- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03346161
Optimizing Decision Making About Breast Reconstruction After Mastectomy: A Patient-Centered Approach
July 26, 2019 updated by: Washington University School of Medicine
Although clinical decision tools (CDTs) exist for a variety of treatments, CDTs designed to support personalized breast reconstruction decisions, particularly about type and timing of reconstruction, are lacking.
The objective of this proposal is to develop and pilot test a clinical decision tool that provides personalized risk information and reflects patients' preferences and clinical needs.
Study Overview
Status
Completed
Conditions
Study Type
Interventional
Enrollment (Actual)
120
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Missouri
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Saint Louis, Missouri, United States, 63110
- Washington University School of Medicine
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
- Newly diagnosed or recurrent breast cancer
- Considering a referral or already referred to a plastic surgeon by their surgical oncologist for possible reconstruction
- Considering or completing a mastectomy.
- Does not have known distant metastatic disease (stage IV disease) at the time of recruitment
- Female.
- English-speaking.
- At least 18 years of age.
- Able to understand and willing to sign an IRB-approved written informed consent document.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: HEALTH_SERVICES_RESEARCH
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Arm 1: BREASTChoice (Decision Tool)
Investigators recruited patients scheduled for a plastic/reconstruction consult.
Investigators identified patients who completed a mastectomy, or were scheduled for one, and considering reconstruction, but didn't have an appointment with a plastic/reconstructive surgeon.
A study team member called the patient to determine their interest and offered for them to come to their scheduled appointment 30 minutes early to meet a coordinator or offered them the option to complete pre-appointment procedures at home.
Patients randomized using computer random assignment.
If the patient didn't have an appointment, she scheduled a convenient time to complete study procedures with research staff.
Patients interacted with the decision tool.
They were asked to answer a survey.
After the appointment, the team collected information consult duration, decision process quality, and measures of shared decision making.
Patient participation was approximately 30 minutes.
|
-Interactive web based tool.
Provides detail about breast reconstruction, asks participant questions about health and medications to personalize risks for breast reconstruction outcome.
The tool also goes into pros/cons of breast reconstruction, talks about differences between types of reconstruction, helps people weigh when to have reconstruction (immediate vs. delayed), shows participants representative photos of breast reconstruction outcomes, and assesses patients' knowledge and preferences
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ACTIVE_COMPARATOR: Arm 2: Enhanced Usual Care (Surgical Care Booklet)
Investigators recruited patients scheduled for plastic/reconstruction consultation.
Investigators identified patients who completed or scheduled a mastectomy, and considering reconstruction, but didn't have an appointment with a plastic/reconstructive surgeon.
A study team member called the patient to determine their interest and offered for them to come to their scheduled appointment 30 minutes early to meet a coordinator or to complete the pre-appointment procedures at home.
Patients were randomized using computer random assignment.
If the patient didn't have an appointment, she scheduled a convenient time to complete study procedures with research staff.
Patients interacted with American Society of Plastic Surgeons booklet "Breast Reconstruction."
They were asked to answer a survey.
After the appointment, the team collected information about consult duration, decision process quality, and measures of shared decision making.
Patient participation was approximately 30 minutes.
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-Booklet from the American Society of Plastic Surgeons about how to choose a breast reconstruction surgeon, what to expect during surgery, what is breast reconstruction, risks of breast reconstruction, recovery, costs, and questions to ask surgeon about breast reconstruction
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percent Correct on the Knowledge Measure (Objective Knowledge Score)
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
To determine whether the CDT increases knowledge about their choice, the investigators will compare objective knowledge scores between participants using the CDT and those who received usual care
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Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
Decisional Conflict (SURE Measure)
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
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Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Decision Process (Decision Quality Index Subscale)
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
|
Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of Life as Measured by the BREAST-Q Questionnaire
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
|
Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Gold Standard Shared Decision Making as Measured by the Top collaboRATE Score
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
|
Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Patient Activation (PAM) as Measured by the Number of Participants Who Agreed With Each Statement
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
-3 questions consisting of the following:
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Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Receipt of Reconstruction
Time Frame: Through follow-up (approximately 6 months)
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Assessed if participants received reconstruction
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Through follow-up (approximately 6 months)
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Type of Reconstruction
Time Frame: Through completion of follow-up (approximately 6 months)
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Assessed what type of reconstruction participants received
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Through completion of follow-up (approximately 6 months)
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Timing of Reconstruction
Time Frame: Through completion of follow-up (approximately 6 months)
|
|
Through completion of follow-up (approximately 6 months)
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Time Spent on Tool
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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How long participants spent on the BREASTChoice tool
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Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Consult Time
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Assessed the time between when the plastic/reconstructive surgeon entered and exited the consult room (not including time spent with a resident, nurse, or other clinical staff)
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Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Usability as Measured by the Computer System Usability Questionnaire (CSUQ)
Time Frame: Through completion of breast consultation appointment (total participant time approximately 30 minutes)
|
|
Through completion of breast consultation appointment (total participant time approximately 30 minutes)
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Mary C Politi, Ph.D., MPH, Washington University School of Medicine
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
January 9, 2018
Primary Completion (ACTUAL)
October 24, 2018
Study Completion (ACTUAL)
October 24, 2018
Study Registration Dates
First Submitted
November 1, 2017
First Submitted That Met QC Criteria
November 14, 2017
First Posted (ACTUAL)
November 17, 2017
Study Record Updates
Last Update Posted (ACTUAL)
September 6, 2019
Last Update Submitted That Met QC Criteria
July 26, 2019
Last Verified
July 1, 2019
More Information
Terms related to this study
Other Study ID Numbers
- 201701045
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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