ArticleCurrent oncology (Toronto, Ont.)2022
Effects and Working Mechanisms of a Multilevel Implementation Program for Applying Shared Decision-Making while Discussing Systemic Treatment in Breast Cancer.
Article in Current oncology (Toronto, Ont.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Effect of a patient decision aid on shared decision making in patients with differentiated thyroid cancer: a randomized controlled trial.The oncologist · 2026Trial
- Involving patient partners as appraisers of shared decision making: an explanatory sequential mixed-methods study.Research involvement and engagement · 2026Article
- Updated International Patient Decision Aid Standards (IPDAS version 5.0): modified Delphi, evidence informed consensus process.BMJ (Clinical research ed.) · 2026Article
- Shared decision-making in pediatric physical therapy: A qualitative study among adolescents, parents, and physical therapists.PloS one · 2026Article
- Advancing Knowledge of Values-Clarification Processes During Complex Decision-Making Among Older Adults With Advanced Cancer: Protocol for a Pilot Randomized Trial Using Simulated Patient-Clinician Encounters.JMIR research protocols · 2025Article
- Nationwide implementation of the international multidisciplinary best-practice for locally advanced pancreatic cancer (PREOPANC-4): study protocol.BMC cancer · 2025Article
- Implementing shared decision-making interventions in breast cancer clinical practice: a scoping review.BMC medical informatics and decision making · 2023Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Enhancing the application of shared decision-making (SDM) is critical for integrating patient preferences in breast cancer treatment choices. We investigated the effect of an adapted multilevel SDM implementation program in breast cancer care. Methods: Breast cancer patients qualifying for (neo)adjuvant systemic treatment were included in a multicenter before−after study. Consultations were audio recorded between June 2018 and July 2019 and analyzed using the five-item Observing Patient Involvement in Decision-Making (OPTION-5) instrument to score SDM application by clinicians. The Shared Decision-Making Questionnaire (SDM-Q-9) was used to rate patients’ perceived SDM level. Consultation duration, decision types, number of options discussed and consultations per patient were monitored. Regression analysis was used to investigate the correlated variables and program components. Results: Mean OPTION-5 scores increased from 33.9 (n = 63) before implementation to 54.3 (n = 49) after implementation (p < 0.001). The SDM-Q-9 scores did not change: 91.1 (n = 51) at baseline versus 88.9 (n = 23) after implementation (p = 0.81). Without increasing consultation time, clinicians discussed more options after implementation. The regression analysis showed that exposure to the implementation program, redistribution of tasks and discussing feedback from consultations was associated with a higher level of SDM. Conclusion: The multilevel program helped clinicians achieve clinically relevant improvement in SDM, especially when it is tailored to (individuals in) teams and includes (e-)training, discussing feedback on consultations and redistribution of tasks.
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Registered trials
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