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Low Use of Decision Aids for Localized Prostate Cancer by Radiation Oncologists and Urologists

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Key Points

  • Among respondents, 37% of radiation oncologists and 34% of urologists reported using decision aids in clinical practice.
  • A total of 17% of radiation oncologists and 16% of urologists reported decision aids as "very useful."

In a survey study reported in JAMA Internal Medicine, Wang et al found that a minority of responding radiation oncologists and urologists used decision aids for localized prostate cancer in clinical practice.

Study Details

In the study, a survey regarding use of and attitudes toward decision aids was mailed to a national random sample of 711 radiation oncologists and 711 urologists in the United States between November 2011 and April 2012. Overall, 44% of radiation oncologists and 46% of urologists responded.

Use and Attitudes

Among respondents, 37% of radiation oncologists and 34% of urologists reported using a decision aid in clinical practice; 17% vs 16% and 71% vs 65% reported decision aids as "very useful" and "somewhat useful," and 10% vs 8% and 64% vs 55% reported that they were "very confident" and "moderately confident" that the aids improved treatment decisions.

Strong and moderate agreement with the statement “Decision aids are applicable to my patients” was reported by 8% and 64% of practitioners not using decision aids and by 46% and 51% of those using decision aids. Strong and moderate agreement with the statement “My estimation of my patient’s risk of recurrence is more accurate than [that provided by] the currently available decision aids” was reported by 6% and 36% of practitioners not using decision aids and by 2.5% and 21% of those using decision aids. 

Professional Society Trust

More than 60% of both radiation oncologists and urologists reported trusting decision aids from the American Cancer Society, American Society of Clinical Oncology, and National Comprehensive Cancer Network. However, whereas 91% of radiation oncologists reported trusting decision aids from the America Society of Radiation Oncology (ASTRO), only 43% trusted decision aids from the American Urological Association (AUA); similarly, whereas 95% of urologists trusted decision aids from AUA, only 42% trusted decision aids from ASTRO.

The investigators concluded: “Use of decision aids among specialists treating patients with prostate cancer is relatively low. Efforts to address barriers to clinical implementation of decision aids may facilitate greater shared decision making for patients diagnosed as having prostate cancer.”

Simon P. Kim, MD, MPH, of Case Western Reserve University School of Medicine, is the corresponding author of the JAMA Internal Medicine article.

The study was supported by awards from the Informed Medical Decisions Foundation and the Conquer Cancer Foundation of the American Society of Clinical Oncology.

Cary P. Gross, MD, and James B. Yu, MD, MHS, are consultants with 21st Century Oncology. Dr. Gross is a consultant with Johnson & Johnson and Metronic.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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