Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer

• Published in: BMC medical informatics and decision making Vol. 12; no. 1; p. 118
• Main Authors: Hofmann, Sabine, Vetter, Janina, Wachter, Christiane, Henne-Bruns, Doris, Porzsolt, Franz, Kornmann, Marko
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23-10-2012; BioMed Central; BMC
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Audiovisual Aids - utilization; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Colorectal cancer; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - radiotherapy; Colorectal Neoplasms - surgery; Combined Modality Therapy; Decision Making; Disease; Drug therapy; Educational Status; Feasibility Studies; Female; Humans; Male; Middle Aged; Mortality; Neoplasm Staging; Patient Participation - psychology; Patient Participation - statistics & numerical data; Patients; Personal Autonomy; Physician-Patient Relations; Postoperative Period; Prospective Studies; Quality of life; Risk Assessment; Shared decision-making; Side effects; Surveys and Questionnaires; Survival Analysis; Visual aids; Germany
• ISSN: 1472-6947; 1472-6947
• DOI: 10.1186/1472-6947-12-118

A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer.
We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265) and to patients with colorectal cancer (n = 102).
Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88%-100%). Patients (79%) chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%). No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant) but without survival benefit.
Healthy persons' and patients' decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.