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020 A digital shared decision-making tool for treatment choices in oligometastatic disease
  1. Nikola Biller-Andorno1,
  2. Armin Biller2,3,
  3. Andrea Ferrario1,
  4. Sebastian M Christ4,5,
  5. Matthias Guckenberger4
  1. 1Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
  2. 2Multi Dimensional Medical Information Lab, University Hospital Heidelberg, Heidelberg, Germany
  3. 3PMB Research, Personal Medical Biography Company, Heidelberg, Germany
  4. 4Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
  5. 5Department of Radiation Oncology, CHUV, Lausanne, Switzerland

Abstract

Introduction Patient preferences are of paramount importance for high-quality, patient-oriented care. In oligometastatic prostate cancer (omPCa), systemic therapy added to local therapy (surgery or radiotherapy) can improve survival. However, a large proportion of patients opts for a local treatment only in order to avoid or delay the toxicity and quality-of-life implications of androgen deprivation therapy. To date, there is no established methodology on how to integrate patient preferences into the complex decision-making process of individualizing multimodality treatment. Our project aims to address this gap by developing a digital shared decision-making tool based on patient reported outcomes measures (PROMS) for designing a personalized treatment strategy.

Methods An existing, pilot-tested generic digital decision aid has been adapted to an omPCa patient population, integrating the information needed to make a well-considered decision on maintenance systemic therapy. The tool is designed such that it can be used as a live digital interface during the consultation, allowing the specialist to add or adjust information pertinent to the individual patient. The result of the shared decision-making process will be documented digitally and thus be easily available for future reference. A prospective oligometastatic patient cohort (n = 150) will be recruited over a period of 18 months and followed up over one year. This mixed methods study will also include a qualitative component exploring in more depth usability (from both patient and provider perspectives), acceptance and fit with clinical routine.

Results and Discussion The project is running from July 2023 to December 2026. We will present the conceptual approach, prototype and study protocol, and share our analysis of the phase I user testing.

Conclusions The presentation of the prototype will not only prompt feedback on the tool itself but invite discussions on the potential, pitfalls and limitations of using digital tools for shared decision-making with oligometastatic patients.

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