ArticleBMC medical informatics and decision making2014
Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy.
Article in BMC medical informatics and decision making, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03136367 (Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer Across Socioeconomic Strata), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer Across Socioeconomic Strata
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are We Improving? Update and Critical Appraisal of the Reporting of Decision Process and Quality Measures in Trials Evaluating Patient Decision Aids.Medical decision making : an international journal of the Society for Medical Decision Making · 2021Pooled it
- Adjuvant endocrine therapy non-initiation and non-persistence in young women with early-stage breast cancer.Breast cancer research and treatment · 2023Trial
- The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (Alliance).Journal of geriatric oncology · 2018Trial
- Effectiveness of a decision aid for patients with depression: A randomized controlled trial.Health expectations : an international journal of public participation in health care and health policy · 2017Trial
- Development and psychometric evaluation of a decision quality instrument for lung cancer screening decisions (DQI-LCS).BMC medical informatics and decision making · 2026Article
- Question Prompt List to Support Patient-Provider Communication in the Use of the 21-Gene Recurrence Test: Feasibility, Acceptability, and Outcomes.JCO oncology practice · 2020Article
- A Tool to Assess Patient and Surrogate Knowledge About the POLST (Physician Orders for Life-Sustaining Treatment) Program.Journal of pain and symptom management · 2019Article
- Article
- How Informed Is the Decision About Breast Reconstruction After Mastectomy?: A Prospective, Cross-sectional Study.Annals of surgery · 2016Article
- Who should decide how much and what information is important in person-centred health care?Journal of health services research & policy · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundWomen diagnosed with early stage (I or II) breast cancer face a highly challenging decision - whether or not to undergo adjuvant chemotherapy. We developed a decision quality instrument for chemotherapy for early stage breast cancer and sought to evaluate its performance.
methodsCross-sectional, mailed survey of recent breast cancer survivors, providers, and healthy controls and a retest survey of survivors. The decision quality instrument includes questions on knowledge and personal goals. It results in a knowledge score and concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, validity, and reliability of the survey instrument were examined.
resultsResponses were received from 352 patients, 89 providers and 35 healthy controls. The decision quality instrument was feasible to implement with few missing data. The knowledge scores had good retest reliability (intraclass correlation coefficient (ICC) =0.75). Knowledge scores discriminated between providers and patients (mean difference 31.1%, 95% CI 26.9, 35.3) and between patients and healthy controls (mean difference 11.2, 95% CI 5.4, 17.1). Most providers reported that the knowledge items covered essential content. Two of the five goal items had a ceiling effect, and one goal had low content validity. The goal items had moderate retest reliability (ICC's 0.57 to 0.78). In the multivariable model of treatment, none of the patient goals was associated with receipt of chemotherapy. Age and hormone receptor status were the only variables independently associated with chemotherapy. Most patients (77.6%) had treatment concordant with that predicted by the model. Patients who had concordant treatment had similar levels of confidence and regret as those who did not.
conclusionsThe Decision Quality Instrument is a reliable and valid measure of patient knowledge about chemotherapy, but its ability to measure concordance with patient goals is limited. In this sample, patient goals were not associated with treatment, and most patients reported they were not asked their preference, suggesting that goals were not adequately considered in decision making.
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Registered trials
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