Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02954900
Other study ID # AAAP4151 I
Secondary ID R01CA177995
Status Completed
Phase N/A
First received
Last updated
Start date March 15, 2016
Est. completion date October 2018

Study information

Verified date January 2021
Source Columbia University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this pilot study is to evaluate a decision support website (RealRisks) designed to inform patients about breast cancer chemoprevention. It is coupled with a physician-centered (BNAV) decision support website as part of clinical workflow in the primary care setting. The investigator hypothesizes that improving accuracy of breast cancer risk perception and understanding of the risks/benefits of chemoprevention will enhance informed decision-making and uptake of breast cancer prevention strategies in the primary care setting.


Description:

Breast cancer is the most common malignancy among women in the U.S. and the primary prevention of this disease is a major public health issue. The U.S. Preventive Services Task Force and other professional organizations recommend that clinicians discuss chemoprevention with high-risk women. Breast cancer chemoprevention with anti-estrogens, such as tamoxifen, raloxifene, exemestane, and anastrozole, is under-utilized, despite several randomized controlled trials demonstrating a 40-65% decrease in breast cancer incidence among high-risk women. Compounding this underutilization is the fact that a large proportion of women may be unaware of their high-risk status due to the investigators inability to adequately screen them in the primary care setting. Further research is needed to determine how knowledge about breast cancer, actual/perceived risk, and risks/benefits of chemoprevention are best communicated to women in order to promote breast cancer prevention strategies. This study assesses risk communication and shared decision-making in patient-clinician dyads by administering validated measures at baseline, after interacting with the tools prior to the clinic visit, and after the clinical visit (quantitative analysis); and by using observer-based methods of audio-tape recordings of their clinical encounters (qualitative analysis). The investigator hypothesizes that combining a patient-centered decision aid with a physician-centered decision support tool integrated into clinic workflow will improve accuracy of breast cancer risk perception, facilitate referrals for specialized risk counseling, and increase chemoprevention uptake.


Recruitment information / eligibility

Status Completed
Enrollment 40
Est. completion date October 2018
Est. primary completion date October 2018
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 35 Years to 75 Years
Eligibility Inclusion Criteria: - 5-year breast risk of 1.67% or lifetime risk of 20% according to the Gail model - The participant understands and is willing to provide informed consent in English or Spanish - Has a primary care provider at Columbia University Medical Center (CUMC) / New York-Presbyterian Hospital Exclusion Criteria: - Prior use of a selective estrogen receptor modulator (SERM) or aromatase inhibitor (AI) for chemoprevention - Prior history of breast cancer

Study Design


Related Conditions & MeSH terms


Intervention

Other:
RealRisks
RealRisks is a web-based patient decision aid with modules that present information about risk assessment and chemoprevention.
BNAV
Breast Cancer Risk Navigation (BNAV) tool is a web-based decision support tool with modules that present pertinent information for primary care providers regarding breast cancer risk assessment and preventative measures for their patients.

Locations

Country Name City State
United States Columbia University Medical Center New York New York

Sponsors (2)

Lead Sponsor Collaborator
Columbia University National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (2)

Kukafka R, Yi H, Xiao T, Thomas P, Aguirre A, Smalletz C, David R, Crew K. Why Breast Cancer Risk by the Numbers Is Not Enough: Evaluation of a Decision Aid in Multi-Ethnic, Low-Numerate Women. J Med Internet Res. 2015 Jul 14;17(7):e165. doi: 10.2196/jmir.4028. — View Citation

Yi H, Xiao T, Thomas PS, Aguirre AN, Smalletz C, Dimond J, Finkelstein J, Infante K, Trivedi M, David R, Vargas J, Crew KD, Kukafka R. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools. AMIA Annu Symp Proc. 2015 Nov 5;2015:1352-60. eCollection 2015. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Change in the accuracy of risk perception (Likert Scale Score) To measure the patient's accuracy of perceived breast cancer risk before and after exposure to the RealRisks decision aid. Perception will be assessed by comparing the difference between a patient's perceived risk and their actual risk based on the Gail breast cancer model. Patients are asked to make a comparative risk assessment about themselves on a 3-point Likert scale. Baseline, 2 weeks
Secondary Change in a patient's breast cancer knowledge (Survey Score) To assess patient's breast cancer knowledge before and after exposure to the RealRisks decision aid by comparing the difference between a patient's responses to a 13-item scale assessing knowledge with response options of true, false, or unsure. Baseline, 2 weeks
Secondary Chemoprevention uptake rate among high-risk women To determine the uptake rate in the breast clinic after offering specialized risk counseling to a broader population of racially/ethnically diverse women screened in the primary care setting. Electronic health records will be used to track chemoprevention uptake after exposure to the RealRisks decision aid. 6 months
Secondary Referral rates to the breast clinic To study appropriate referral rate by primary care providers of high-risk patients to the breast clinic. 12 months
See also
  Status Clinical Trial Phase
Enrolling by invitation NCT05558917 - Comparison Between PECS BLOCK 2 vs ESP BLOCK in Ocnologic Breast Surgery N/A
Active, not recruiting NCT03664778 - Abbreviated Breast MRI After Cancer Treatment
Recruiting NCT03144622 - 18F-FSPG PET/CT Imaging in Patients With Cancers
Completed NCT05452499 - Pain Neuroscience Education and Therapeutic Exercise as a Treatment for Breast Cancer Survivors Living With Sequelae N/A
Active, not recruiting NCT04568902 - Study of H3B-6545 in Japanese Women With Estrogen Receptor (ER)-Positive, Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Breast Cancer Phase 1
Completed NCT02860585 - Evaluation of Survival in Patients With Metastatic Breast Cancer Receiving High-dose Chemotherapy With Autologous Haematopoietic Stem Cell Transplantation N/A
Completed NCT04059809 - Photobiomodulation for Breast Cancer Radiodermatitis Phase 2/Phase 3
Recruiting NCT04557449 - Study to Test the Safety and Tolerability of PF-07220060 in Participants With Advance Solid Tumors Phase 1/Phase 2
Completed NCT03698942 - Delphinus SoftVueâ„¢ ROC Reader Study
Completed NCT00092950 - Exercise in Women at Risk for Breast Cancer Phase 2
Terminated NCT04123704 - Sitravatinib in Metastatic Breast Cancer Phase 2
Not yet recruiting NCT02151071 - The Breast Surgery EnLight and LightPath Imaging System Study Phase 1/Phase 2
Recruiting NCT02934360 - TR(ACE) Assay Clinical Specimen Study N/A
Active, not recruiting NCT02950064 - A Study to Determine the Safety of BTP-114 for Treatment in Patients With Advanced Solid Tumors With BRCA Mutations Phase 1
Completed NCT02931552 - Nuevo Amanecer II: Translating a Stress Management Program for Latinas N/A
Not yet recruiting NCT02876848 - A Novel E-Health Approach in Optimizing Treatment for Seniors (OPTIMUM Study) N/A
Recruiting NCT02547545 - Breast Cancer Chemotherapy Risk Prediction Mathematical Model N/A
Completed NCT02652975 - Anticancer Treatment of Breast Cancer Related to Cardiotoxicity and Dysfunctional Endothelium N/A
Completed NCT02518477 - Preventive Intervention Against Lymphedema After Breast Cancer Surgery N/A
Completed NCT02303366 - Pilot Study of Stereotactic Ablation for Oligometastatic Breast Neoplasia in Combination With the Anti-PD-1 Antibody MK-3475 Phase 1