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. 2023 May 31:14:1162537.
doi: 10.3389/fendo.2023.1162537. eCollection 2023.

Patient decision aids for patients with differentiated thyroid carcinoma: development process and alpha and beta testing

Anna Koot  1   2 , Rosella Hermens  3 , Petronella Ottevanger  4 , Romana Netea-Maier  2 , Peep Stalmeier  1 ; COMBO study group
Collaborators, Affiliations

Patient decision aids for patients with differentiated thyroid carcinoma: development process and alpha and beta testing

Anna Koot et al. Front Endocrinol (Lausanne). .

Abstract

Background: Patient decision aids (PtDAs) are structured clinical tools that facilitate shared decision-making. Two important treatment decisions for patients with differentiated thyroid cancer (DTC), which could benefit from PtDAs, are as follows (1): the extent of surgery decision in patients with low-risk DTC and (2) the decision to start or delay starting the treatment with tyrosine kinase inhibitors (TKIs) in patients with advanced tumors.

Material and methods: PtDAs for these two decisions were developed using the International Patient Decision Aids Standards (IPDAS) quality criteria in an iterative process of prototype development via alpha and beta testing by patients and physicians. The information content of the PtDAs was based on the available literature, current guidelines, and patient's needs, preferences, and values.

Results: The web-based PtDAs underwent two rounds of alpha testing, revisions, and beta testing. The PtDAs have the same structure, consisting of six steps: a general introduction, information about the treatment options, comparing the treatment options, knowledge questions, a values clarification exercise, and saving the information. The alpha testing (n = 8 patients, n = 10 physicians) showed that the PtDAs were highly acceptable and usable for decision-making. Results of the beta testing in 20 patients showed that two patients did not use the PtDA; the other 18 patients found that the PtDAs were readable (n = 17) and helpful (n = 14) for decision-making. All patients recommend using the PtDAs.

Conclusions: Evidence-based PtDAs were created for patients with DTC for two different treatment decisions. Our final version was judged to be clear, balanced, and helpful in decision-making.

Keywords: decision aid; shared decision making; surgery; thyroid cancer; tyrosine kinase inhibitor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Development process of the patient’s decision aids.
Figure 2
Figure 2
Overview of the different decision aids in the Netherlands.
Figure 3
Figure 3
Example of the values clarification exercise of the extent of surgery PtDA (translated from Dutch into English).
See this image and copyright information in PMC

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