Introduction
Methods
Data sources and search strategy
Inclusion and exclusion criteria
Study and decision aid selection
Assessment of decision aids
Quality of decision aids
Communicative aspects of decision aids
Results
Search results and decision aid characteristics
ID | Title | Organization/authors | Country | Treatment discussed | Last update | Format |
---|---|---|---|---|---|---|
1 | Mastectomy or breast-conserving therapy | Harwood (2011) | AUS | BCS; mastectomy | Aug 2008 | Paper |
2 | Axillary dissection or a sentinel node biopsy | Harwoord (2011) | AUS | Lymph node surgery | Aug 2008 | Paper |
3 | Understanding ductal carcinoma in situ (DCIS) and deciding about treatment | National breast and ovarian cancer center | AUS | BCS; mastectomy; radiotherapy; hormonal therapy | 2010 | Paper |
4 | Frankly speaking about cancer: breast reconstruction | Cancer support community | USA | Reconstruction surgery | 2012 | Paper |
5 | Surgery choices for women with DCIS or breast cancer | National cancer institute | USA | BCS; mastectomy; reconstruction surgery; lymph node surgery | Nov 2012 | Paper |
6 | A guide for women who are considering breast cancer treatment with chemotherapy and/or hormonal therapy before surgery | Australia and new zealand breast cancer trial group (ANZBCTG) Zdenkowski (2016, 2018) | AUS | (Neo)adjuvant chemotherapy; (Neo)adjuvant hormonal therapy | Dec 2014 | Paper |
7 | A patchwork of life: One woman’s story. For women making breast cancer treatment decisions | Dan L. Duncan comprehensive cancer center, Jabaja-Weiss (2006, 2011) | USA | BCS; mastectomy; reconstruction surgery; radiotherapy; hormonal therapy; chemotherapy | Aug 2015 | Web |
8 | Early-stage breast cancer: Choosing your treatment | Health dialog | USA | BCS; mastectomy; reconstruction surgery; radiotherapy; lymph node surgery | Jul 2016 | Paper |
9 | iCanDecide | Cancer surveillance and outcomes research team, University of Michigan, Hawley (2017a, 2017b, 2018) | USA | BCS; mastectomy; reconstruction surgery; radiotherapy; chemotherapy; hormonal therapy | 2017 | Web |
10 | Breast reconstruction: Is it right for you? | Health dialog | USA | Reconstruction surgery | Jul 2017 | Paper |
11 | Keuzehulp borstkanker | PATIENT+ | NL | BCS; mastectomy; radiotherapy | Aug 2017 | Web |
12 | Keuzehulp borstreconstructie | PATIENT+ | NL | Reconstruction surgery | Aug 2017 | Web |
13 | Breast RECONstruction decision aid (BRECONDA) | Breast cancer network Australia, Westmead breast cancer institute, Macquarie University, Sherman (2016) | AUS | Reconstruction surgery | Oct 2017 | Web |
14 | OPTIONS: what are my options for breast cancer treatment? | Wong (2011) | CAN | Radiotherapy; hormonal therapy | Oct 2017 | Paper |
15 | Breast cancer surgery options | Allina Health | USA | BCS; mastectomy; radiotherapy | 2018 | Paper |
16 | Borstreconstructie keuzehulp | Zorgkeuzelab | NL | Reconstruction surgery | Jan 2018 | Web |
17 | Breast cancer: should I have breast reconstruction after a mastectomy? | Healthwise | USA | Reconstruction surgery | Mar 2018 | Web |
18 | Breast cancer: should I have chemotherapy for early-stage breast cancer? | Healthwise | USA | Chemotherapy | Mar 2018 | Web |
19 | Breast cancer: should I have breast-conserving surgery or a mastectomy for early-stage breast cancer? | Healthwise | USA | BCS; mastectomy | Mar 2018 | Web |
20 | Borstkanker keuzehulp | Zorgkeuzelab Maastricht UMC+ | NL | BCS; mastectomy; reconstruction surgery; radiotherapy; chemotherapy | Oct 2018 | Web |
21 | Borstkanker RAdiotherapie SAmen beslissen (BRASA) | MAASTRO Clinic, Maastricht University, Netherlands Cancer Institute | NL | Radiotherapy | Oct 2018 | Web |
DA ID | First author, year | Country | Study design | Study population | Methods | Results |
---|---|---|---|---|---|---|
1,2 | Harwood, 2011 | AUS | Development/Evaluation and pilot study | Development/Evaluation study: women who had already had surgery for breast cancer (stages I and II, n = 28) Pilot study: newly diagnosed patients with early breast cancer (stages not mentioned, n = 11) | There were two phases of this study. The first phase involved patients evaluating the two DAs, and the second phase involved determining the effectiveness of the DAs. During both phases, study outcomes were treatment chosen, patient knowledge, decisional conflict, and satisfaction with decision-making. | Patients in the historical control group reported positive feedback on the DAs, and patients in the intervention pilot group found the DAs to be helpful. Results from the pilot study suggested a possible reduction in decisional conflict, and increase in decisional satisfaction, knowledge, and choice of axillary clearance (instead of sentinel node biopsy) in the intervention pilot group. |
6 | Zdenkowski, 2016 | AUS | Development/protocol evaluation study | Newly diagnosed patients with invasive and operable breast cancer (target n = 50) | A pre-post design will be used to evaluate the acceptability and feasibility of the DA. Primary outcomes will be acceptability and feasibility, and secondary outcomes will be decision conflict, knowledge, information and involvement preference, agreement between preferred and achieved decision. | N.A. |
6 | Zdenkowski, 2018 | AUS | Evaluation study (pre-post design) | Newly diagnosed patients with operable invasive breast cancer (n = 59) | Patients first completed a baseline questionnaire (test 1), subsequently received the DA prior to consultation, and then completed a follow-up questionnaire after consultation (test 2), before surgery (test 3) and 12 months after registration (test 4). Study outcomes: as above. | The DA was found to be feasible (with most patients having accessing it) and acceptable (with the majority of the patients seeing the DAs as useful for their decision about treatment). Moreover, post-DA, decisional conflict, anxiety, and distress decreased significantly. |
7 | Jibaja-Weiss, 2006 | USA | Evaluation study | Newly diagnosed patients with early breast cancer (stages I–IIIA, n = 51) | Patients answered a number of questions after diagnosis, and after completing the DA. Study outcomes were patients’ use of the values clarification exercise, perceived clarity of values, and decision conflict scores (low literacy version). | Over half of the participants performed the values clarification exercise. The use of the DA was associated with lower levels of decisional conflict (compared to baseline scores) and lower levels of feeling unclear about values. |
7 | Jibaja-Weiss, 2011 | USA | RCT | Newly diagnosed patients with early breast cancer (stages I–IIIA, n = 76) | Patients were randomized to either the intervention group (DA plus usual care) or the control group (usual care only). Study outcomes were treatment preference, breast cancer knowledge, satisfaction with decision, satisfaction with decision-making process, and decision conflict (low literacy version). | Patients who received the DA were more likely to indicate a preference for mastectomy rather than breast-conserving surgery, were more knowledgeable and clearer about their values compared to the control group. No differences were found in satisfaction with the decision or the decision-making process between the two groups. |
9 | Hawley, 2016 | USA | Evaluation and pilot study | Newly diagnosed patients with early breast cancer (stage 0, I, or II, n = 101) | Patients were randomized to either the intervention group (who viewed the DA first) or the control group (who took a survey prior to viewing the DA). Study outcomes for the evaluation were knowledge (about treatment options and breast cancer) and decisional appraisal. | Patients who viewed the DA first had higher scores on decisional appraisal than the control group. However, no statistically significant differences were found in knowledge about treatment options between the two groups. |
9 | Hawley, 2017 | USA | RCT protocol | Newly diagnosed patients with early breast cancer (DCIS, or stage I–II, target n = 222 per arm) | A two-arm RCT will be conducted to evaluate the impact of a tailored DA (intervention group) on decision quality, decision satisfaction, deliberation, and decision preparedness (as primary study outcomes) compared to the same non-tailored static DA (control group). | N.A. |
9 | Hawley, 2018 | USA | RCT | Newly diagnosed patients with early breast cancer (stage I–II, n = 496) | Patients were randomly allocated to the intervention group (tailored DA) or control group (non-tailored static DA). Primary study outcome was high-quality decision-making (which consisted of (1) knowledge about risks and benefits of treatment options and (2) values-concordant treatment). | The use of a tailored DA was positively associated with high-quality decisions compared to using a non-tailored DA. Furthermore, patients in the intervention group had higher levels of knowledge than the control group. However, no differences were found in values-concordant treatment decisions between the two groups. |
13 | Sherman, 2016 | AUS | RCT | Newly diagnosed patients with early breast cancer or ductal carcinoma in situ (DCIS, stages I–III, n = 222) | An RCT was conducted to determine the effectiveness of a DA for deciding whether to have breast reconstruction or not. Patients were randomized to either the intervention group (DA + plus standard information) or the control group (standard information). Study outcomes were decisional conflict, satisfaction with information, and decisional regret (1 and 6 months after exposure). | At both 1- and 6-month follow-up, the use of the DA was associated with lower levels of decisional conflict and higher levels of satisfaction with the information compared to the control group. There were no differences in decisional regret between the two groups. |
14 | Wong, 2011 | CAN | Development and evaluation study | Development study: patients with early breast cancer who had already had radiotherapy (stage I, n = 12) Evaluation study: Newly diagnosed patients with early breast cancer (stage I, n = 36) | There were two pilot studies in this study. The first involved the development of the DA in which patients were asked to review the acceptability of the aid. The second pilot was a pre-post test aimed at examining the effectiveness of the DA on decisional conflict, knowledge, impact of event, and treatment choice. | The majority of patients rated the DA as (extremely) satisfied. In comparison to the baseline scores (pre-test), patients experienced less decisional conflict and were more knowledgeable after using the DA (post-test). |