Decision aids (DAs) can improve knowledge for prostate cancer treatment. However, the relative effects of DAs delivered within the clinical encounter and in more diverse patient populations are unknown. A multicenter cluster randomized controlled trial with a 2×2 factorial design was performed to test the effectiveness of within-visit and previsit DAs for localized prostate cancer, and minority men were oversampled.
The interventions were delivered in urology practices affiliated with the NCI Community Oncology Research Program Alliance Research Base. The primary outcome was prostate cancer knowledge (percent correct on a 12-item measure) assessed immediately after a urology consultation.
Four sites administered the previsit DA (39 patients), 4 sites administered the within-visit DA (44 patients), 3 sites administered both previsit and within-visit DAs (25 patients), and 4 sites provided usual care (50 patients). The median percent correct in prostate cancer knowledge, based on the postvisit knowledge assessment after the intervention delivery, was as follows: 75% for the pre+within-visit DA study arm, 67% for the previsit DA only arm, 58% for the within-visit DA only arm, and 58% for the usual-care arm. Neither the previsit DA nor the within-visit DA had a significant impact on patient knowledge of prostate cancer treatments at the prespecified 2.5% significance level (P = .132 and P = .977, respectively).
DAs for localized prostate cancer treatment provided at 2 different points in the care continuum in a trial that oversampled minority men did not confer measurable gains in prostate cancer knowledge.
Cancer. 2021 Dec 10 [Epub ahead of print]
Jon C Tilburt, David Zahrieh, Joel E Pacyna, Daniel G Petereit, Judith S Kaur, Bruce D Rapkin, Robert L Grubb, George J Chang, Michael J Morris, Evan Z Kovac, Kara N Babaian, Jeff A Sloan, Ethan M Basch, Elizabeth S Peil, Amylou C Dueck, Paul J Novotny, Electra D Paskett, Jan C Buckner, Daniel D Joyce, Victor M Montori, Dominick L Frosch, Robert J Volk, Simon P Kim
Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota., Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota., Rapid City Regional Cancer Care Institute, Monument Health, Rapid City, South Dakota., Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida., Department of Epidemiology and Population Health, Division of Community Collaboration and Implementation Science, Albert Einstein College of Medicine, Bronx, New York., Department of Urology, Medical University of South Carolina, Charleston, South Carolina., Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York., Department of Urology, Rutgers New Jersey Medical School, Newark, New Jersey., Department of Surgery, Southern Illinois University, Springfield, Illinois., Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina., Alliance Statistics and Data Center, Mayo Clinic, Scottsdale, Arizona., Ohio State University College of Medicine, The Ohio State University, Columbus, Ohio., Department of Oncology, Mayo Clinic, Rochester, Minnesota., Department of Urology, Mayo Clinic, Rochester, Minnesota., Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota., Palo Alto Medical Foundation Research Institute, Palo Alto, California., Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas., Division of Urology, Anschutz Medical Center, University of Colorado, Aurora, Colorado.