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Clinics were randomized to time of transition from usual care (UC) to delivery of a web\u2010based DA. Patients with stage 0 through 3 breast cancer being considered for surgery were enrolled. Knowledge (primary outcome) was measured using the Breast Cancer Surgery Decision Quality Instrument and patients were asked, \u201cHow informed do you feel?\u201d Intervention effects were tested with linear mixed\u2010effects models, accounting for surgeon and clinic\u2010level clustering, time, and enrollment after COVID. Additional models controlled for demographics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 44% of DA arm patients reviewed the DA and 58% in UC arm reported reviewing \u201cany information.\u201d Being in the DA arm versus UC was not associated with knowledge. However, \u201creview of information\u201d was associated with higher knowledge. In addition, non\u2010White race and lower education were associated with lower knowledge. The DA arm was associated with higher perceptions of feeling informed (parameter estimate 1.36; 95% CI, 0.18\u20132.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.02); this persisted even when controlling for review of information or demographics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improved knowledge was not demonstrate with a web\u2010based DA versus UC. Interestingly, the DA was associated with a higher likelihood of feeling informed. Future research will explore the discrepancy between patients feeling informed but having low knowledge, especially for disadvantaged patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT0376600<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70314","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T11:12:09Z","timestamp":1770808329000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of a web\u2010based breast cancer surgery decision aid on knowledge and perceptions of feeling informed in clinics that care for socioeconomically disadvantaged patients: An Alliance Clinical Trial (A231701CD)"],"prefix":"10.1002","volume":"132","author":[{"given":"Jessica 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