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Evaluating a Decision Aid for Sentinel Lymph Node Biopsy in Intermediate-Risk Melanoma (Mel73)

2026년 6월 11일 업데이트: Russell G. Witt, University of Virginia

This research study is testing a decision aid to help patients think through whether to have sentinel lymph node biopsy for melanoma.

Sentinel lymph node biopsy (SLNB) can be a difficult decision for some patients because the potential benefits and risks may not be clear. This study is being done to learn whether providing structured, easy-to-understand information helps patients feel more informed and less uncertain about their decision.

Patients in this study will be given a paper decision aid (DA). Patients will be given other short questionnaires to complete before and after the decision aid.

연구 개요

상태

아직 모집하지 않음

개입 / 치료

상세 설명

The melanoma-specific decision aid (DA) is a structured, evidence-based informational tool designed to support shared decision-making regarding sentinel lymph node biopsy (SLNB). The DA includes: (1) a plain-language explanation of melanoma staging and the purpose of SLNB; (2) individualized estimates of SLNB positivity risk based on the MIA risk model; (3) a balanced presentation of the potential benefits, risks, and uncertainties associated with SLNB; and (4) a values clarification component prompting patients to reflect on personal preferences related to risk tolerance, diagnostic certainty, and potential downstream treatment implications. The decision aid is provided to patients prior to surgical consultation and is reviewed during the clinic visit to facilitate structured discussion between the patient and surgeon. The decision aid does not provide treatment recommendations and does not replace physician counseling.

Immediately after written informed consent and before reviewing the decision aid, patients will complete baseline questionnaires reflecting their understanding and feelings following standard-of-care counseling alone. These baseline measures include:

  • Decisional conflict questionnaire: A validated multi-item questionnaire that assesses uncertainty, clarity of values, feeling informed, and confidence in decision-making regarding sentinel lymph node biopsy.
  • Melanoma sentinel lymph node biopsy knowledge questionnaire: A brief study-specific knowledge assessment evaluating patient understanding of the purpose of sentinel lymph node biopsy, potential benefits, risks, and areas of uncertainty.
  • Anxiety questionnaire: (State Trait Anxiety Inventory [STAI-6]) A validated short-form questionnaire assessing situational anxiety related to the clinical consultation and upcoming decision.
  • Health literacy assessment: A brief validated word-recognition screening tool to assess health literacy.
  • Demographic and contextual factors: Including residential zip code (for rurality and travel distance), insurance category, and basic socioeconomic indicators.

After reviewing the decision aid and participating in a brief follow-up discussion with the clinician, patients will complete post-decision aid questionnaires, including:

  • Decisional conflict questionnaire (post): Re-administered to assess change in decisional conflict following use of the decision aid.
  • Melanoma sentinel lymph node biopsy knowledge questionnaire (post): Re-administered to assess change in knowledge.
  • Anxiety questionnaire (post): Re-administered to assess whether use of the decision aid increases, decreases, or does not change anxiety levels.
  • Final decision regarding sentinel lymph node biopsy: Documented as proceeding with or declining the procedure.
  • Decision Aid Evaluation form: a brief written questionnaire assessing usability, clarity, perceived value of the DA.

A 30-day chart review will document whether SLNB was ultimately performed.

연구 유형

중재적

등록 (추정된)

66

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

    • Virginia
      • Charlottesville, Virginia, 미국, 22908
        • University of Virginia Health System

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  1. Adults (≥18 years old) with a histologically confirmed diagnosis of cutaneous melanoma.
  2. Clinical stage I or II disease, for whom sentinel lymph node biopsy (SLNB) is being considered.
  3. Patients with either:

    • An estimated risk of sentinel lymph node metastasis between 5 and 10 percent based on the MIA risk calculator, or
    • A discordant risk scenario will be defined as a case in which the individualized probability of sentinel lymph node metastasis predicted by the MIA model falls into a different risk category (<5%, 5-10%, or >10%) than the category suggested by clinicopathologic staging features used in NCCN guideline-based counseling.
  4. Willingness and ability to comply with study procedures.
  5. Ability to provide informed consent.
  6. Pregnant women, and other vulnerable populations are not specifically excluded unless they meet other exclusion criteria; the study presents minimal risk.

Exclusion Criteria:

  1. Patients with clinical evidence of nodal or distant metastatic disease at the time of consultation.
  2. Patients with prior sentinel lymph node biopsy or nodal surgery for the current melanoma diagnosis.
  3. Inability to speak or read English.
  4. Inability or unwillingness to provide informed consent.
  5. Prisoners

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 지지 요법
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Decision Aid Arm
Participants in this arm will receive the Decision Aid intervention. Participants will be asked to complete pre- and post- intervention questionnaires. All participants will be assigned to this arm.
The melanoma-specific decision aid is a structured, evidence-based informational tool designed to support shared decision-making regarding sentinel lymph node biopsy. The DA is a paper based tool that includes: (1) a plain-language explanation of melanoma staging and the purpose of SLNB; (2) individualized estimates of SLNB positivity risk based on the MIA risk model; (3) a balanced presentation of the potential benefits, risks, and uncertainties associated with SLNB; and (4) a values clarification component prompting patients to reflect on personal preferences related to risk tolerance, diagnostic certainty, and potential downstream treatment implications. The decision aid is provided to patients prior to surgical consultation and is reviewed during the clinic visit to facilitate structured discussion between the patient and surgeon. The decision aid does not provide treatment recommendations and does not replace physician counseling.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Decisional conflict score
기간: From the time of enrollment to the end of the intervention on Day 1
Change in decisional conflict score from pre-decision aid to post-decision aid, measured using a validated questionnaire (Decisional Conflict Scale - DCS).
From the time of enrollment to the end of the intervention on Day 1

2차 결과 측정

결과 측정
측정값 설명
기간
Sentinel lymph node biopsy knowledge questionnaire
기간: From the time of enrollment to the end of the intervention on Day 1
Change in patient knowledge regarding sentinel lymph node biopsy.
From the time of enrollment to the end of the intervention on Day 1
Consultation-related anxiety (STAI-6 questionnaire)
기간: From the time of enrollment to the end of the intervention on Day 1
Change in consultation-related anxiety using the STAI-6 validated questionnaire
From the time of enrollment to the end of the intervention on Day 1
Sentinel lymph node biopsy decision
기간: 30 days post-clinic visit
The proportion of patient participants who elect to undergo sentinel lymph node biopsy after decision aid-supported consultation
30 days post-clinic visit
Patient-reported acceptability of the Decision Aid
기간: Within 48 hours of the intervention on Day 1
The Decision Aid Evaluation Form will be used to describe patient-reported acceptability of the decision aid. This questionnaire utilizes Likert-scale items and an optional, written, free-text response section.
Within 48 hours of the intervention on Day 1
Feasibility of Decision Aid implementation in the clinic workflow
기간: From the time of enrollment to the end of the intervention on Day 1
Proportion of eligible patients successfully completing review of the decision aid during the clinic visit
From the time of enrollment to the end of the intervention on Day 1

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Russell Witt, MD, University of Virginia

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 6월 1일

기본 완료 (추정된)

2028년 1월 1일

연구 완료 (추정된)

2028년 1월 1일

연구 등록 날짜

최초 제출

2026년 6월 8일

QC 기준을 충족하는 최초 제출

2026년 6월 11일

처음 게시됨 (실제)

2026년 6월 17일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 6월 17일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 6월 11일

마지막으로 확인됨

2026년 6월 1일

추가 정보

이 연구와 관련된 용어

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

흑색종(피부암)에 대한 임상 시험

Decision Aid에 대한 임상 시험

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