Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Oral Oncol. 2021 Dec;123:105618. doi: 10.1016/j.oraloncology.2021.105618. Epub 2021 Nov 22.
Many patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) have the option of radiation- or surgery-based therapy, and would benefit from a treatment decision aid (DA) to make decisions congruent with their personal values. Our objective was to develop a patient-centered DA for patients with OPSCC that is comprehensible, usable, acceptable, and well-designed.
Decisional needs from a pilot study of OPSCC survivors and treating physicians were used to inform a web-based prototype DA. A multidisciplinary steering group developed and iteratively revised the DA. Feasibility testing was conducted in two cycles to assess perspectives of stakeholders (medical, radiation and surgical oncologists, patient education experts, and OPSCC survivors). Survey data and open-ended responses were used to evaluate and refine the DA.
16 physicians, 4 patient education experts, and 6 survivors of OPSCC evaluated a web-based DA prototype in two cycles of testing. Participant feedback was used to revise the DA content and design between cycles. The majority of participants across both cycles indicated that the DA was comprehensible (97%), usable (86%), acceptable (78%), and well-designed (93%). Approximately three quarters of respondents indicated that they would use or share the DA in clinical practice.
We developed the first patient-centered treatment decision aid (DA) designed for patients with OPSCC, to our knowledge. The DA was perceived favorably by stakeholders, with more than three quarters of respondents indicating they would use it in clinical practice. This tool may improve clinical practice as an adjunct to shared decision-making for OPSCC.
许多被诊断患有口咽鳞状细胞癌（OPSCC）的患者可以选择放疗或手术治疗，如果有一种治疗决策辅助工具（DA）可以帮助他们做出符合个人价值观的决策，将对他们有所帮助。我们的目标是为 OPSCC 患者开发一种以患者为中心的 DA，使其具有可理解性、可用性、可接受性和良好的设计。
从 OPSCC 幸存者和治疗医生的试点研究中获取决策需求，以告知基于网络的原型 DA。一个多学科指导小组开发并迭代修改了 DA。在两个周期中进行了可行性测试，以评估利益相关者（医学、放射和外科肿瘤学家、患者教育专家和 OPSCC 幸存者）的观点。调查数据和开放式回答用于评估和完善 DA。
在两轮测试中，16 名医生、4 名患者教育专家和 6 名 OPSCC 幸存者评估了一个基于网络的 DA 原型。参与者的反馈用于在两轮测试之间修改 DA 的内容和设计。两轮测试中，大多数参与者表示 DA 具有可理解性（97%）、可用性（86%）、可接受性（78%）和良好的设计（93%）。大约四分之三的受访者表示他们将在临床实践中使用或分享该 DA。
据我们所知，这是第一个为 OPSCC 患者设计的以患者为中心的治疗决策辅助工具（DA）。利益相关者对 DA 的评价较为积极，超过四分之三的受访者表示他们将在临床实践中使用该工具。该工具可作为 OPSCC 患者共同决策的辅助手段，改善临床实践。
