Shared decision making and use of decision aids for localized prostate cancer: Perceptions from radiation oncologists and urologists

Elyn H. Wang, Cary P. Gross, Jon C. Tilburt, James B. Yu, Paul L. Nguyen, Marc C. Smaldone, Nilay D. Shah, Robert Abouassally, Maxine Sun, Simon P. Kim

Research output: Contribution to journalArticle

Abstract

IMPORTANCE The current attitudes of prostate cancer specialists toward decision aids and their use in clinical practice to facilitate shared decision making are poorly understood. OBJECTIVE To assess attitudes toward decision aids and their dissemination in clinical practice. DESIGN, SETTING, AND PARTICIPANTS A surveywas mailed to a national random sample of 1422 specialists (711 radiation oncologists and 711 urologists) in the United States from November 1, 2011, through April 30, 2012. MAIN OUTCOMES AND MEASURES Respondentswere asked about familiarity, perceptions, and use of decision aids for clinically localized prostate cancer and trust in various professional societies in developing decision aids. The Pearson ÷2 test was used to test for bivariate associations between physician characteristics and outcomes. RESULTS Similar response rates were observed for radiation oncologists and urologists (44.0% vs 46.1%; P =.46). Although most respondents had some familiarity with decision aids, only 35.5%currently use a decision aid in clinic practice. The most commonly cited barriers to decision aid use included the perception that their ability to estimate the risk of recurrence was superior to that of decision aids (7.7%in those not using decision aids and 26.2%in those using decision aids; P >.001) and the concern that patients could not process information from a decision aid (7.6%in those not using decision aids and 23.7%in those using decision aids; P >.001). In assessing trust in decision aids established by various professional medical societies, specialists consistently reported trust in favor of their respective organizations, with 9.2%being very confident and 59.2%being moderately confident (P =.01). CONCLUSIONS AND RELEVANCE Use of decision aids among specialists treating patients with prostate cancer is relatively low. Efforts to address barriers to clinical implementation of decision aids may facilitate greater shared decision making for patients diagnosed as having prostate cancer.

Original languageEnglish (US)
Pages (from-to)792-799
Number of pages8
JournalJAMA Internal Medicine
Volume175
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Decision Support Techniques
Prostatic Neoplasms
Decision Making
Radiation Oncologists
Urologists
Aptitude
Medical Societies

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

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Shared decision making and use of decision aids for localized prostate cancer : Perceptions from radiation oncologists and urologists. / Wang, Elyn H.; Gross, Cary P.; Tilburt, Jon C.; Yu, James B.; Nguyen, Paul L.; Smaldone, Marc C.; Shah, Nilay D.; Abouassally, Robert; Sun, Maxine; Kim, Simon P.

In: JAMA Internal Medicine, Vol. 175, No. 5, 01.05.2015, p. 792-799.

Research output: Contribution to journalArticle

Wang, EH, Gross, CP, Tilburt, JC, Yu, JB, Nguyen, PL, Smaldone, MC, Shah, ND, Abouassally, R, Sun, M & Kim, SP 2015, 'Shared decision making and use of decision aids for localized prostate cancer: Perceptions from radiation oncologists and urologists', JAMA Internal Medicine, vol. 175, no. 5, pp. 792-799. https://doi.org/10.1001/jamainternmed.2015.63
Wang, Elyn H. ; Gross, Cary P. ; Tilburt, Jon C. ; Yu, James B. ; Nguyen, Paul L. ; Smaldone, Marc C. ; Shah, Nilay D. ; Abouassally, Robert ; Sun, Maxine ; Kim, Simon P. / Shared decision making and use of decision aids for localized prostate cancer : Perceptions from radiation oncologists and urologists. In: JAMA Internal Medicine. 2015 ; Vol. 175, No. 5. pp. 792-799.
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abstract = "IMPORTANCE The current attitudes of prostate cancer specialists toward decision aids and their use in clinical practice to facilitate shared decision making are poorly understood. OBJECTIVE To assess attitudes toward decision aids and their dissemination in clinical practice. DESIGN, SETTING, AND PARTICIPANTS A surveywas mailed to a national random sample of 1422 specialists (711 radiation oncologists and 711 urologists) in the United States from November 1, 2011, through April 30, 2012. MAIN OUTCOMES AND MEASURES Respondentswere asked about familiarity, perceptions, and use of decision aids for clinically localized prostate cancer and trust in various professional societies in developing decision aids. The Pearson ÷2 test was used to test for bivariate associations between physician characteristics and outcomes. RESULTS Similar response rates were observed for radiation oncologists and urologists (44.0{\%} vs 46.1{\%}; P =.46). Although most respondents had some familiarity with decision aids, only 35.5{\%}currently use a decision aid in clinic practice. The most commonly cited barriers to decision aid use included the perception that their ability to estimate the risk of recurrence was superior to that of decision aids (7.7{\%}in those not using decision aids and 26.2{\%}in those using decision aids; P >.001) and the concern that patients could not process information from a decision aid (7.6{\%}in those not using decision aids and 23.7{\%}in those using decision aids; P >.001). In assessing trust in decision aids established by various professional medical societies, specialists consistently reported trust in favor of their respective organizations, with 9.2{\%}being very confident and 59.2{\%}being moderately confident (P =.01). CONCLUSIONS AND RELEVANCE Use of decision aids among specialists treating patients with prostate cancer is relatively low. Efforts to address barriers to clinical implementation of decision aids may facilitate greater shared decision making for patients diagnosed as having prostate cancer.",
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AB - IMPORTANCE The current attitudes of prostate cancer specialists toward decision aids and their use in clinical practice to facilitate shared decision making are poorly understood. OBJECTIVE To assess attitudes toward decision aids and their dissemination in clinical practice. DESIGN, SETTING, AND PARTICIPANTS A surveywas mailed to a national random sample of 1422 specialists (711 radiation oncologists and 711 urologists) in the United States from November 1, 2011, through April 30, 2012. MAIN OUTCOMES AND MEASURES Respondentswere asked about familiarity, perceptions, and use of decision aids for clinically localized prostate cancer and trust in various professional societies in developing decision aids. The Pearson ÷2 test was used to test for bivariate associations between physician characteristics and outcomes. RESULTS Similar response rates were observed for radiation oncologists and urologists (44.0% vs 46.1%; P =.46). Although most respondents had some familiarity with decision aids, only 35.5%currently use a decision aid in clinic practice. The most commonly cited barriers to decision aid use included the perception that their ability to estimate the risk of recurrence was superior to that of decision aids (7.7%in those not using decision aids and 26.2%in those using decision aids; P >.001) and the concern that patients could not process information from a decision aid (7.6%in those not using decision aids and 23.7%in those using decision aids; P >.001). In assessing trust in decision aids established by various professional medical societies, specialists consistently reported trust in favor of their respective organizations, with 9.2%being very confident and 59.2%being moderately confident (P =.01). CONCLUSIONS AND RELEVANCE Use of decision aids among specialists treating patients with prostate cancer is relatively low. Efforts to address barriers to clinical implementation of decision aids may facilitate greater shared decision making for patients diagnosed as having prostate cancer.

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