Austria Mia, Kimberlin Colin, Le Tiffany, Lynch Kathleen A, Ehdaie Behfar, Atkinson Thomas M, Vickers Andrew J, Carlsson Sigrid V
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.
MDM Policy Pract. 2023 Mar 11;8(1):23814683231156427. doi: 10.1177/23814683231156427. eCollection 2023 Jan-Jun.
To evaluate patient perceptions of a Web-based decision aid for the treatment of localized prostate cancer. We assessed patient perceptions of a multicomponent, Web-based decision aid with a preference elicitation/values clarification exercise using adaptive conjoint analysis, the generation of a summary report, and provision of information about localized prostate cancer treatment options. Using a think-aloud approach, we conducted 21 cognitive interviews with prostate cancer patients presented with the decision aid prior to seeing their urologist. Thematic content analysis was used to examine patient perceptions of the tool's components and content prior to engaging in shared decision making with their clinician. Five themes were identified: 1) patients had some negative emotional reactions to the tool, pointing out what they perceived to be unnecessarily negative framing and language used; 2) patients were forced to stop and think about preferences while going through the tool and found this deliberation to be useful; 3) patients were confused by the tool; 4) patients tried to discern the intent of the conjoint analysis questions; and 5) there was a disconnect between patients' negative reactions while using the tool and a contrasting general satisfaction with the final "values profile" created by the tool. Studies are needed to explore the disconnect between patients' expressing negative reactions while going through some components of decision aids but satisfaction with the final output. In particular, we hypothesize that this effect might be explained by cognitive biases such as choice-supportive bias, hindsight bias, and the "IKEA effect." This is one of the first projects to elicit patient reactions while they were completing a decision aid, and we recommend further similar, qualitative postprocess evaluation studies.
We explored perceptions of a decision aid with education about localized prostate cancer treatment and preference elicitation using adaptive conjoint analysis.Patients found the tool useful but were also confused by it, tried to discern the intent of the questions, and expressed negative emotional reactions.In particular, there was a disconnect between patients' negative reactions while using the tool and general satisfaction with the final values profile generated by the tool, which is an area for future research.
为评估患者对用于局部前列腺癌治疗的基于网络的决策辅助工具的看法。我们通过使用适应性联合分析、生成总结报告以及提供有关局部前列腺癌治疗方案的信息，对一个多组件、基于网络的决策辅助工具进行了偏好诱导/价值观澄清练习，以此来评估患者的看法。我们采用出声思考法，对21名前列腺癌患者进行了认知访谈，这些患者在看泌尿科医生之前接触了该决策辅助工具。在患者与临床医生进行共同决策之前，采用主题内容分析法来检查患者对该工具的组成部分和内容的看法。确定了五个主题：1）患者对该工具有一些负面情绪反应，指出他们认为其中使用的框架和语言不必要地消极；2）患者在使用该工具时被迫停下来思考偏好，并发现这种思考是有用的；3）患者对该工具感到困惑；4）患者试图理解联合分析问题的意图；5）患者在使用该工具时的负面反应与对该工具生成的最终“价值观概况”的普遍满意度之间存在脱节。需要开展研究来探讨患者在经历决策辅助工具的某些组成部分时表达负面反应但对最终结果感到满意之间的脱节现象。特别是，我们假设这种效应可能由诸如选择支持性偏差、后见之明偏差和“宜家效应”等认知偏差来解释。这是首批在患者完成决策辅助工具时引发其反应的项目之一，我们建议开展进一步类似的定性后处理评估研究。
我们探讨了一个决策辅助工具的看法，该工具提供有关局部前列腺癌治疗的教育并使用适应性联合分析进行偏好诱导。患者发现该工具有用，但也对其感到困惑，试图理解问题的意图，并表达了负面情绪反应。特别是，患者在使用该工具时的负面反应与对该工具生成的最终价值观概况的普遍满意度之间存在脱节，这是未来研究的一个领域。
