TY - JOUR
T1 - Informing patients with esophagogastric cancer about treatment outcomes by using a web-based tool and training: Development and evaluation study
AU - van de Water, Loïs F.
AU - van den Boorn, H. ctor G.
AU - Hoxha, Florian
AU - Henselmans, Inge
AU - Calff, Mart M.
AU - Sprangers, Mirjam A. G.
AU - Abu-Hanna, Ameen
AU - Smets, Ellen M. A.
AU - van Laarhoven, Hanneke W. M.
N1 - Funding Information: Financial support for this study was provided entirely by a grant from the Dutch Cancer Society (grant UVA 2014-7000). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, and writing and publishing the report. The funder had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Funding Information: The authors developed and evaluated the web-based tool Source and the accompanying training described in this study. HWMVL reports grants from the Dutch Cancer Society during the conduct of the study and personal fees from Bristol Myers Squibb, Lilly, and Nordic Pharma; and grants and nonfinancial support from Bayer, Bristol Myers Squibb, Celgene, Jansen, Lilly, Nordic Pharma, Philips, Roche, and Servier outside this work. In addition, HWMVL has a consultant or advisory role with Bristol Myers Squibb, Lilly, MSD, Nordic Pharma, and Servier. Publisher Copyright: © 2021 Loïs F van de Water, Héctor G van den Boorn, Florian Hoxha, Inge Henselmans, Mart M Calff, Mirjam A G Sprangers, Ameen Abu-Hanna, Ellen M A Smets, Hanneke W M van Laarhoven.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background: Due to the increasing use of shared decision-making, patients with esophagogastric cancer play an increasingly important role in the decision-making process. To be able to make well-informed decisions, patients need to be adequately informed about treatment options and their outcomes, namely survival, side effects or complications, and health-related quality of life. Web-based tools and training programs can aid physicians in this complex task. However, to date, none of these instruments are available for use in informing patients with esophagogastric cancer about treatment outcomes. Objective: This study aims to develop and evaluate the feasibility of using a web-based prediction tool and supporting communication skills training to improve how physicians inform patients with esophagogastric cancer about treatment outcomes. By improving the provision of treatment outcome information, we aim to stimulate the use of information that is evidence-based, precise, and personalized to patient and tumor characteristics and is communicated in a way that is tailored to individual information needs. Methods: We designed a web-based, physician-assisted prediction tool-Source-to be used during consultations by using an iterative, user-centered approach. The accompanying communication skills training was developed based on specific learning objectives, literature, and expert opinions. The Source tool was tested in several rounds-a face-to-face focus group with 6 patients and survivors, semistructured interviews with 5 patients, think-aloud sessions with 3 medical oncologists, and interviews with 6 field experts. In a final pilot study, the Source tool and training were tested as a combined intervention by 5 medical oncology fellows and 3 esophagogastric outpatients. Results: The Source tool contains personalized prediction models and data from meta-analyses regarding survival, treatment side effects and complications, and health-related quality of life. The treatment outcomes were visualized in a patient-friendly manner by using pictographs and bar and line graphs. The communication skills training consisted of blended learning for clinicians comprising e-learning and 2 face-to-face sessions. Adjustments to improve both training and the Source tool were made according to feedback from all testing rounds. Conclusions: The Source tool and training could play an important role in informing patients with esophagogastric cancer about treatment outcomes in an evidence-based, precise, personalized, and tailored manner. The preliminary evaluation results are promising and provide valuable input for the further development and testing of both elements. However, the remaining uncertainty about treatment outcomes in patients and established habits in doctors, in addition to the varying trust in the prediction models, might influence the effectiveness of the tool and training in daily practice. We are currently conducting a multicenter clinical trial to investigate the impact that the combined tool and training have on the provision of information in the context of treatment decision-making.
AB - Background: Due to the increasing use of shared decision-making, patients with esophagogastric cancer play an increasingly important role in the decision-making process. To be able to make well-informed decisions, patients need to be adequately informed about treatment options and their outcomes, namely survival, side effects or complications, and health-related quality of life. Web-based tools and training programs can aid physicians in this complex task. However, to date, none of these instruments are available for use in informing patients with esophagogastric cancer about treatment outcomes. Objective: This study aims to develop and evaluate the feasibility of using a web-based prediction tool and supporting communication skills training to improve how physicians inform patients with esophagogastric cancer about treatment outcomes. By improving the provision of treatment outcome information, we aim to stimulate the use of information that is evidence-based, precise, and personalized to patient and tumor characteristics and is communicated in a way that is tailored to individual information needs. Methods: We designed a web-based, physician-assisted prediction tool-Source-to be used during consultations by using an iterative, user-centered approach. The accompanying communication skills training was developed based on specific learning objectives, literature, and expert opinions. The Source tool was tested in several rounds-a face-to-face focus group with 6 patients and survivors, semistructured interviews with 5 patients, think-aloud sessions with 3 medical oncologists, and interviews with 6 field experts. In a final pilot study, the Source tool and training were tested as a combined intervention by 5 medical oncology fellows and 3 esophagogastric outpatients. Results: The Source tool contains personalized prediction models and data from meta-analyses regarding survival, treatment side effects and complications, and health-related quality of life. The treatment outcomes were visualized in a patient-friendly manner by using pictographs and bar and line graphs. The communication skills training consisted of blended learning for clinicians comprising e-learning and 2 face-to-face sessions. Adjustments to improve both training and the Source tool were made according to feedback from all testing rounds. Conclusions: The Source tool and training could play an important role in informing patients with esophagogastric cancer about treatment outcomes in an evidence-based, precise, personalized, and tailored manner. The preliminary evaluation results are promising and provide valuable input for the further development and testing of both elements. However, the remaining uncertainty about treatment outcomes in patients and established habits in doctors, in addition to the varying trust in the prediction models, might influence the effectiveness of the tool and training in daily practice. We are currently conducting a multicenter clinical trial to investigate the impact that the combined tool and training have on the provision of information in the context of treatment decision-making.
KW - Communication skills training
KW - Esophageal cancer
KW - Gastric cancer
KW - Patient-physician communication
KW - Prediction tool
KW - Risk communication
KW - Shared decision-making
KW - Treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=85114041227&partnerID=8YFLogxK
U2 - https://doi.org/10.2196/27824
DO - https://doi.org/10.2196/27824
M3 - Article
C2 - 34448703
SN - 2291-5222
VL - 23
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 8
M1 - e27824
ER -