Evidence map›Paper›PMID 39690895›Full record

ArticleCancer medicine2024

Feasibility of implementing a decision aid for advanced cancer patients in a comprehensive cancer centers' outpatient setting: Valuable lessons learned.

K Laryionava, R Boekels, J Schildmann, M Wensing, U Wedding, B Surmann, K Mehlis, C Gebel, M Cinci, K Krug and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

K LaryionavaDepartment of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
R BoekelsDepartment of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
J SchildmannInstitute for History and Ethics of Medicine, Centre for Health Sciences, Martin Luther University Halle-Wittenberg (Saale), Halle (Saale), Germany.ORCID 0000-0002-5755-7630
M WensingDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
U WeddingDepartment of Internal Medicine II (Palliative Care), University of Jena, Jena, Germany.
B SurmannHealth Economics and Health Care Management, Bielefeld University, Bielefeld, Germany.
K MehlisDepartment of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
C GebelDepartment of Internal Medicine II (Palliative Care), University of Jena, Jena, Germany.
M CinciDepartment of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
K KrugDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
E C WinklerDepartment of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.ORCID 0000-0001-7460-0154

Funding

Deutsche Krebshilfe 70113243
6 · The paper itself

Abstract

backgroundDecision aids (DAs) have been proposed as tools to empower patients in decision-making. However, implementing DA for decisions in advanced cancer is challenging. This study focuses on perspectives of oncologists and other healthcare providers on the hindering and facilitating factors for implementing a customizable DA. This DA is designed to support discussions about whether patients with advanced, incurable cancers should pursue or forgo further anticancer treatment.

methodsThis qualitative study utilized content analysis following Sandelowski's approach on two different datasets derived from research projects on decision-making in advanced cancer. To inform the development of a DA and understand challenges related to its implementation, we conducted semi-structured interviews with 24 oncologists (Dataset 1) and three focus groups with various healthcare professionals (n = 19) and in addition post-implementation semi-structured interviews with oncologists who used the DA in conversations with their cancer patients (n = 5) (Dataset 2). Furthermore, the insights from process evaluation of developing and implementing the DA in an outpatients' settings was incorporated, enriching the analytical framework.

resultsTwo overall themes emerged: (1) Tension between standardizing the use of a DA and responding to individual patient needs. To address this conflict, a two-part DA was developed, combining structured elements with flexibility. (2) Prerequisites for the use of the DA in outpatients' settings: Senior physicians' support, education in palliative care options and in the use of the DA, and organizational conditions.

conclusionOncologists identified both structural and content-related aspects for a successful implementation of a DA for patients with advanced cancer. While the content-related aspects were factored into the development of the DA, structural (organizational) issues need to be especially focused on during implementation.

Indexed as

Decision Support TechniquesFeasibility StudiesNeoplasmsCancer Care FacilitiesFemaleFocus GroupsHumansMaleMiddle AgedOncologistsOutpatientsPatient ParticipationQualitative Researchadvanced cancerdecision aidforgoing of cancer treatmentimplementation researchqualitative study

Identifiers

PMID39690895
PMCPMC11652780

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.