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Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer.
MedLine Citation:
PMID:  23395006     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women's decisions about prophylactic tamoxifen and raloxifene use. METHODS: Postmenopausal women, age 46-74, with BCRAT 5-year risk ≥1.66% and no prior history of breast cancer were randomized to one of three study arms:intervention (n=690), Time 1 control (n=160), or 3-month control (n=162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women's decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively. RESULTS: Intervention participants had significantly lower decisional conflict levels at post-test (p<0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p<0.001) compared to control participants. CONCLUSION: GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk. PRACTICE IMPLICATIONS: Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients' decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values.
Matthew P Banegas; Jennifer B McClure; William E Barlow; Peter A Ubel; Dylan M Smith; Brian J Zikmund-Fisher; Sarah M Greene; Angela Fagerlin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-7
Journal Detail:
Title:  Patient education and counseling     Volume:  -     ISSN:  1873-5134     ISO Abbreviation:  Patient Educ Couns     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8406280     Medline TA:  Patient Educ Couns     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by Elsevier Ireland Ltd.
University of Washington, Department of Health Services, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Electronic address:
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