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onlineDeCISion.org: a web-based decision aid for DCIS treatment

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Women diagnosed with DCIS face complex treatment decisions and often do so with inaccurate and incomplete understanding of the risks and benefits involved. Our objective was to create a tool to guide these decisions for both providers and patients. We developed a web-based decision aid designed to provide clinicians with tailored information about a patient’s recurrence risks and survival outcomes following different treatment strategies for DCIS. A theoretical framework, microsimulation model (Soeteman et al., J Natl Cancer 105:774–781, 2013) and best practices for web-based decision tools guided the development of the decision aid. The development process used semi-structured interviews and usability testing with key stakeholders, including a diverse group of multidisciplinary clinicians and a patient advocate. We developed onlineDeCISion.org to include the following features that were rated as important by the stakeholders: (1) descriptions of each of the standard treatment options available; (2) visual projections of the likelihood of time-specific (10-year and lifetime) breast-preservation, recurrence, and survival outcomes; and (3) side-by-side comparisons of down-stream effects of each treatment choice. All clinicians reviewing the decision aid in usability testing were interested in using it in their clinical practice. The decision aid is available in a web-based format and is planned to be publicly available. To improve treatment decision making in patients with DCIS, we have developed a web-based decision aid onlineDeCISion.org that conforms to best practices and that clinicians are interested in using in their clinics with patients to better inform treatment decisions.

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Acknowledgments

This work was supported by contract HHSA290200500161 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in this article are those of the authors, and no official endorsement by AHRQ or the U.S. Department of Health and Human Services is intended or should be inferred.

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Authors and Affiliations

  1. Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, 35 Centerra Parkway, Lebanon, NH, 03766, USA

    Elissa M. Ozanne

  2. Baylor College of Medicine, Houston, TX, USA

    Katharine H. Schneider

  3. Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, 2nd Floor, Boston, MA, 02115, USA

    Djøra Soeteman

  4. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

    Natasha Stout

  5. Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02115, USA

    Deborah Schrag & Rinaa S. Punglia

  6. Center for Collaborative and Interactive Technologies and the John M. Eisenberg Center for Clinical Decisions and Communications Science, Baylor College of Medicine, One Baylor Plaza, MS: BCM: 155, Houston, TX, 77030-3411, USA

    Michael Fordis

Authors
  1. Elissa M. Ozanne
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  2. Katharine H. Schneider
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  3. Djøra Soeteman
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  4. Natasha Stout
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  5. Deborah Schrag
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  6. Michael Fordis
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  7. Rinaa S. Punglia
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Corresponding author

Correspondence to Elissa M. Ozanne.

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Ozanne, E.M., Schneider, K.H., Soeteman, D. et al. onlineDeCISion.org: a web-based decision aid for DCIS treatment. Breast Cancer Res Treat 154, 181–190 (2015). https://doi.org/10.1007/s10549-015-3605-y

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  • DOI: https://doi.org/10.1007/s10549-015-3605-y

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