PHYSICIANS OPINIONS ABOUT DECISION AIDS FOR PATIENTS CONSIDERING SYSTEMIC ADJUVANT THERAPY FOR AXILLARY-NODE NEGATIVE BREAST-CANCER

Purpose: To examine variations in physicians' opinions about the appro priateness and content of decision aids for women with breast cancer a nd criteria for their evaluation Methods: Cross-sectional survey of al l 144 Ontario oncologists by Dillman's mailed survey design. The respo nse rate was 87%. Results: The predominant current practice pattern wa s to spontaneously inform patients about the treatment recommendations , degree of certainty regarding the recommendations, treatment regime, benefits and side effects. Most respondents (94%) endorsed patient de cision aids, particularly when there was high uncertainty about provid ing adjuvant treatment. Over three-quarters endorsed measuring the fol lowing outcomes of decision aids: patients' clarity of trade-offs invo lved (e.g. survival vs. side effects); comprehension of treatment alte rnatives, risks and benefits; accuracy of expectations; decision satis faction; anxiety; commitment to the decision; length of time to comple te the decision aid; and decision uncertainty. The least support was f or the use of the decision itself as an outcome measure. Conclusions: There is considerable consensus regarding the indications for, content and criteria for evaluating decision aids which should be considered when developing aids relevant to the needs of clinicians and patients.