Trial reportAnnals of surgical oncology2025
Impact of a Web-Based Decision Aid on Socioeconomically Disadvantaged Patients' Engagement in Breast Surgery Decision-Making: Stepped-Wedge Clinical Trial (Alliance-A231701CD).
Trial report in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of Decision Aids for Shared Decision-Making for Patients with Early Stage Breast Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2026Pooled it
- Providing information to prepare breast cancer patients for their surgical consultation: barriers and recommendations (an analysis from Alliance A231701CD).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Trial
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundDecision aids (DAs) may increase engagement in decision-making by addressing barriers that disproportionately impact socioeconomically disadvantaged patients. The impact of a breast cancer surgery DA on increasing patient engagement in decision-making was tested in clinics serving a high proportion of socioeconomically disadvantaged patients.
methodsA stepped-wedge trial was conducted with 10 National Cancer Institute Community Oncology Research Program clinics (Alliance for Clinical Trials in Oncology, June 2019 to December 2021). The clinics were randomized to time of transition from usual care (UC) to delivery of a web-based DA. Patients with stages 0-3 breast cancer eligible for surgery provided consent before a surgical consultation. Engagement was measured by Patient's Self-Efficacy in Patient-Physician Interactions (PEPPI-5, follow-up survey) and count of Active Patient Behaviors (audio-recorded consultation). Intervention effects were tested with linear mixed-effects models, accounting for surgeon and clinic-level clustering, time, and enrollment after COVID. Heterogeneity of treatment effect by socioeconomic disadvantage (using the Area Deprivation Index) was assessed with an interaction term.
resultsThe study enrolled 576 patients, and 44 % (136/309) of the patients reviewed the DA. No significant difference in engagement was observed between DA and UC for PEPPI-5 (- 0.8; 95 % CI, - 2.1-0.6; p = 0.260) or Active Patient Behaviors (2.5; 95 % CI, - 4.1-9.2; p = 0.456). No heterogeneity of treatment effect was observed. Socioeconomic disadvantage was associated with fewer Active Patient Behaviors (- 5.9; 95 % CI, - 0.6-- 1.2; p = 0.013).
conclusionThis trial conducted in clinics that serve diverse populations, observed no significant relationship between a web-based DA and patient engagement. Future analyses will explore DA implementation, characteristics of patients who reviewed the DA, and persistent barriers to engagement.
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