Breast Cancer Clinical Trial
Official title:
Optimizing Decision Making About Breast Reconstruction After Mastectomy: A Patient-Centered Approach
Verified date | July 2019 |
Source | Washington University School of Medicine |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Although clinical decision tools (CDTs) exist for a variety of treatments, CDTs designed to support personalized breast reconstruction decisions, particularly about type and timing of reconstruction, are lacking. The objective of this proposal is to develop and pilot test a clinical decision tool that provides personalized risk information and reflects patients' preferences and clinical needs.
Status | Completed |
Enrollment | 120 |
Est. completion date | October 24, 2018 |
Est. primary completion date | October 24, 2018 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years and older |
Eligibility |
- Newly diagnosed or recurrent breast cancer - Considering a referral or already referred to a plastic surgeon by their surgical oncologist for possible reconstruction - Considering or completing a mastectomy. - Does not have known distant metastatic disease (stage IV disease) at the time of recruitment - Female. - English-speaking. - At least 18 years of age. - Able to understand and willing to sign an IRB-approved written informed consent document. |
Country | Name | City | State |
---|---|---|---|
United States | Washington University School of Medicine | Saint Louis | Missouri |
Lead Sponsor | Collaborator |
---|---|
Washington University School of Medicine |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percent Correct on the Knowledge Measure (Objective Knowledge Score) | To determine whether the CDT increases knowledge about their choice, the investigators will compare objective knowledge scores between participants using the CDT and those who received usual care | Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Primary | Decisional Conflict (SURE Measure) | To determine whether the CDT reduces uncertainty about choice. Participants are asked to report how sure they feel about their choice, if they have enough information to understand the choice, if they are clear about the risks and benefits, and if they have enough support to make a choice. Results are compared between the BREASTChoice and Enhanced Usual Care groups. Higher SURE values indicate certainty in choice Scores range from 0-4 |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Primary | Decision Process (Decision Quality Index Subscale) | The total points are summed and then divided by the total number of items to result in scores from 0-100%, with higher scores indicating a more shared decision making process Assess the extent to which patients were meaningfully involved in decision-making with their clinicians |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Quality of Life as Measured by the BREAST-Q Questionnaire | Assessed 4 subscales: satisfaction with breasts, psychosocial well-being, physical well-being, and sexual well-being Score from 0 (worst) to 100 (best). Higher scores reflect a better outcome. |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Gold Standard Shared Decision Making as Measured by the Top collaboRATE Score | Top collaboRATE score = the percentage of patients from whom there was 'gold standard' shared decision making as assessed by the collaboRATE measure The top score is coded as '1', if the response to all three collaboRATE items was less than 9. Then the investigators calculated the percentage of all encounters that were coded as '1' indicating gold standard shared decision making. |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Patient Activation (PAM) as Measured by the Number of Participants Who Agreed With Each Statement | -3 questions consisting of the following: I am confident I can tell my healthcare provider concerns that I have about breast reconstruction even when he or she does not ask (confidence in healthcare provider) I am confident I can find trustworthy sources of information about my breast reconstruction decision (confidence in trustworthy sources) I know the different options available for breast reconstruction (knowledge on breast reconstruction options) |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Receipt of Reconstruction | Assessed if participants received reconstruction | Through follow-up (approximately 6 months) | |
Secondary | Type of Reconstruction | Assessed what type of reconstruction participants received | Through completion of follow-up (approximately 6 months) | |
Secondary | Timing of Reconstruction | Assessed timing of reconstruction Immediate is defined as reconstruction at the time of mastectomy Delayed is defined as reconstruction any time after the mastectomy and performed as a separate surgery |
Through completion of follow-up (approximately 6 months) | |
Secondary | Time Spent on Tool | How long participants spent on the BREASTChoice tool | Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Consult Time | Assessed the time between when the plastic/reconstructive surgeon entered and exited the consult room (not including time spent with a resident, nurse, or other clinical staff) | Through completion of breast consultation appointment (total participant time approximately 30 minutes) | |
Secondary | Usability as Measured by the Computer System Usability Questionnaire (CSUQ) | Assessed ease of usability of the BREASTChoice tool Scale is from 1 (strongly disagree) to 7 (strongly agree) |
Through completion of breast consultation appointment (total participant time approximately 30 minutes) |
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