Decision aid on radioactive iodine treatment for early stage papillary thyroid cancer: update to study protocol with follow-up extension.

Anna M Sawka,Kevin E Thorpe,David P Goldstein,Shereen Ezzat,Sharon Straus,Amiram Gafni,Gary Rodin

doi:10.1186/s13063-015-0819-6

Anna M Sawka, Kevin E Thorpe + Show 5 more

Open Access

https://doi.org/10.1186/s13063-015-0819-6

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Abstract

BackgroundPatient decision aids (P-DAs) are used to inform patients about healthcare choices, but there is limited knowledge about their longer term effects, beyond the time period of decision-making.Methods/DesignWe developed a computerized P-DA that explains the choice of radioactive iodine (RAI) adjuvant treatment or no RAI, for patients with low risk papillary thyroid cancer after total thyroidectomy. The original protocol for a randomized controlled trial, comparing the use of the P-DA (with usual care) to usual care alone, has been published in Trialshttp://www.trialsjournal.com/content/11/1/81. We found that P-DA (with usual care) significantly improved patients’ medical knowledge at the time of decision-making (primary outcome) compared to usual care alone (control). In this update, we present the protocol for an extended follow-up study (15 to 23 months post-randomization), including qualitative and quantitative methods. The patient outcomes evaluated using quantitative questionnaires include: the degree to which patients feel well-informed about their RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, mood, and trust in the treating physician. The qualitative component explores the experiences of RAI treatment decision-making, treatment satisfaction, and trial participation in a representative subgroup of patients. Extended follow-up study results will be described for the entire study population, and data will be compared between the P-DA and control groups.Result and ConclusionThis mixed methods extended follow-up study will provide data on long term outcomes, relating to the use of a computerized P-DA in decision-making about adjuvant RAI treatment in early stage papillary thyroid cancer.DiscussionOur results are intended to inform future research in this area, particularly relating to long term effects of the use of P-DAs in making healthcare choices.Trial registrationClinicaltrials.gov identifier NCT01083550, registered 24 February 2010 and last updated 5 January 2015

Highlights

Patient decision aids (P-DAs) are used to inform patients about healthcare choices, but there is limited knowledge about their longer term effects, beyond the time period of decision-making
We previously developed a computerized patient decision aid (P-DA) that explains the choice of radioactive iodine (RAI) adjuvant treatment or no RAI, for patients with low risk papillary thyroid cancer after total thyroidectomy
Patients’ perceptions of malignancy threat, relative to the valuation of negative aspects of the treatment, strongly influenced RAI treatment choice [8]. In another pre-planned secondary analysis, in which we explored the relationship between individual information preference and knowledge acquisition in PDA users, we found that individuals with a high monitoring information preference accessed more detailed information from our P-DA program [9]