- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03375801
Implementing a Decision Aid for Breast Cancer and DCIS Patients Deciding on Their Radiation Treatment. (BRASA)
Implementing a Decision Aid for Breast Cancer and DCIS Patients Deciding on Their Radiation Treatment: A Pre- and Post-intervention Study.
Study Overview
Detailed Description
Rationale: Guidelines on breast cancer treatment show grey areas for some radiotherapy (RT) indications. In some recommendations the uncertainty is marked and deferred to sharing the final decision on the treatment of choice with the patient. Other recommendations are straightforward, but the multidisciplinary team may decide, based on the latest literature, that different options should be discussed with the patient. In these so called "preference sensitive decisions" there is not one best option. The best option depends on the individual patients' preferences based on neutral and complete information tailored to her own situation. Decision aids support clinicians as well as patients in Shared Decision Making (SDM). Decision aids reduce the patient's decisional conflict after making their decision, increase their knowledge on their illness and the treatment options, and their perceived level of involvement in the decision making process. Although extensive research has been carried out on the effect of decision aids in clinical trials, less is known of the effect of a decision aid in daily clinical practice. The implementation of SDM is challenged by many barriers. The investigators hypothesize that adapting the decision aid to individual patient characteristics may enhance both personalised medicine and SDM.
Objective: To investigate whether SDM using a personalised decision aid, results in improved outcomes of decisional quality, measured by the Decisional Conflict Scale after 3 months and one year, and improved outcomes of the decisional process, measured with the SDMQ9 and collaboRATE directly after the last consultation, compared to the standard clinical practices in breast cancer patients facing a decision on their radiation treatment.
Study design: This is a multicenter clustered , pre- and post-intervention study. Before the intervention 164 patients will be included. After introducing the decision aid, at the beginning of the intervention period, clinicians will be trained in using the decision aid and the other 164 patients will be recruited.
Study population: Breast cancer patients facing a decision in their adjuvant radiation treatment.
Intervention: The intervention group will receive the instructions and the online decision aid.
Main study parameters/endpoints: Primary endpoint: Decisional conflict 3 months after the decision has been made. Secondary endpoint(s): The perceived level of shared decision making, patient knowledge, , and decisional conflict 1 year after decision has been made. A process evaluation will also be perform.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Gelderland
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Nijmegen, Gelderland, Netherlands, 6525 GA
- Radboud UMC
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Limburg
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Maastricht, Limburg, Netherlands
- Maastricht University
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Maastricht, Limburg, Netherlands, 6229 ET
- MAASTRO-clinic
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Noord-Holland
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Amsterdam, Noord-Holland, Netherlands, 1105 AZ
- Academisch Medisch Centrum (AMC)
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Amsterdam, Noord-Holland, Netherlands
- NKI-AVL
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18 years or older
- Female
Doubtful indication of:
- Whole breast irradiation after lumpectomy for DCIS
- Whole breast irradiation after lumpectomy for low risk invasive BC (TOP-1 study)
- Boost dose in case of Breast Conserving Therapy
- Thoracic wall irradiation post mastectomy
Exclusion Criteria:
- Metastasis
- Inability to speak and read Dutch. Inability to use internet access, either in the home or at a hospital facility.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: control group/pre intervention
the first 164 patients will receive care as usual and will make the decision together with their clinician without support of the decision aid.
They will be asked to fill out the questionnaires.
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|
Experimental: intervention arm
another 164 patients will receive the decision aid as support for the decision making process with their clinician.
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This will be an online tool giving evidence based information and explanation on their options.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Decisional conflict
Time Frame: 90 days after the decision on their radiation treatment has been made
|
measured with on the decisional conflict scale. Measured by the decisional conflict scale ( O'Connor, 1995), This contains 16 questions answered on a 5 point likert scale( strongly agree-strongly disagree). Items are given a score value of 0-4. The total score is calculated by: summed, divided by 16 and multiplied by 25. scores range from 0 ( no decisional conflict to 100 (extreme high decisional conflict). The scale also consist of 5 subscales: uncertainty subscore, informed subscore, values subscore, support subscore and the effective decision subscore. |
90 days after the decision on their radiation treatment has been made
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Improvement on the perceived level of shared decision making.
Time Frame: 90 days after the decision on their radiation treatment has been made
|
measured with the 9-item Shared Decision Making questionnaire (SDM-Q-9,( Kriston 2009)).
This contains 9 questions answered on a 6 point likert scale, ranging from 0 ( completely disagree) to 5 ( completely agree).
The total score is calculated by: summed score multiplied by 2.2222 transforming to a scale from 0 to 100.
|
90 days after the decision on their radiation treatment has been made
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Improvement on the perceived level of shared decision making.
Time Frame: 90 days after the decision on their radiation treatment has been made
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measured with the collaboRATE questionnaire ( Barr 2014), This contains 3 questions answered on a 10 point anchored scale, ranging from 0 ( no effort was made) to 9 ( every effort was made).
The total score is calculated by: summed score multiplied by 3.704 transforming to a scale from 0 ( no effort made) to 100 (every effort made).
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90 days after the decision on their radiation treatment has been made
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Patient knowledge
Time Frame: directly after the decision on adjuvant RT has been made (<3 days)
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measured with a ( self developed) knowledge test.
This contains 11 questions with 3 possible answers ( True, not true and don't know).
For every right answered question 1 point, wrong answers -1 and don't know 0 are given resulting in a range from -11 ( all answers wrong) to 11 ( all answers right).
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directly after the decision on adjuvant RT has been made (<3 days)
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Decisional conflict
Time Frame: 365 days after the decision on adjuvant RT has been made
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measured with on the decisional conflict scale Measured by the decisional conflict scale ( O'Connor, 1995), This contains 16 questions answered on a 5 point likert scale( strongly agree-strongly disagree). Items are given a score value of 0-4. The total score is calculated by: summed, divided by 16 and multiplied by 25. scores range from 0 ( no decisional conflict to 100 (extreme high decisional conflict). The scale also consist of 5 subscales: uncertainty subscore, informed subscore, values subscore, support subscore and the effective decision subscore. |
365 days after the decision on adjuvant RT has been made
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Prospective process evaluation
Time Frame: directly after the decision on adjuvant RT has been made (<3 days)
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how many patients did effectively use the decision aid and how many consultations were needed for the decision to be made.
Measured by a log system on the decision aid and by consulting the patients on how many consultations they hade before making the decision.
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directly after the decision on adjuvant RT has been made (<3 days)
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Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- M17SDM
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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