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Because a large, randomized, controlled evaluation trial failed to show effects regarding the primary and secondary outcomes after 4\u00a0weeks, we used postmarket surveillance data for further analyses. The aim of this study was to analyze the immediate effects of using a PC decision aid on decisional conflict, distress, and knowledge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 2,245 patients used the PC decision aid between 05\/2023 and 01\/2024. We applied identical validated instruments before and after use to record immediate effects in an intra-individual comparison; the endpoints were decisional conflict (Decisional Conflict Scale, DCS), distress (Distress Thermometer), and objective knowledge (Decision Quality Worksheet).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Complete data were available for 880 patients (39.2%). The mean patient age was 66.3\u2009\u00b1\u20097.2 (range 43\u201384) years. The DCS score improved from 37.5\u2009\u00b1\u200923.7 before to 20.1\u2009\u00b1\u200915.7 after using the decision aid (p\u2009&lt;\u20090.001). This effect was consistent across all the DCS subscales: level of information, clarity, support, and uncertainty. The Distress Thermometer (0: no distress; to 10: maximum distress) showed an improvement of 3.1 points from 6.2\u2009\u00b1\u20092.6 to 3.1\u2009\u00b1\u20092.6 (p\u2009&lt;\u20090.001). Objective knowledge significantly improved for 4 out of the 5 questions, with differences in absolute percentages of correct answers ranging from 18.8% to 30%. The number of correct answers before vs. after using the PC decision aid increased from 2.3\u2009\u00b1\u20091.1 to 3.0\u2009\u00b1\u20091.1 (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conjunction with the results of our previous work, we can now report strong immediate effects that diminish over a period of four weeks: the evaluated online PC decision aid reduces decisional conflict and distress and improves patient knowledge. These results provide further support for offering this tool to all suitable patients. An ongoing randomized controlled study will address the current study limitations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06368-3","type":"journal-article","created":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T05:11:16Z","timestamp":1775365876000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An online decision aid for patients with prostate cancer evaluating local treatment options reduces decisional conflict and distress and improves knowledge: Postmarket surveillance in German routine care"],"prefix":"10.1007","volume":"44","author":[{"given":"Philipp","family":"Karschuck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Reimold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luka","family":"Flegar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Sch\u00f6nberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ihrig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Krones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Kn\u00f6ll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"W\u00fclfing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice Stephan","family":"Michel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer","family":"Groeben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Huber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"6368_CR1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1097\/SLA.0000000000003444","volume":"271","author":"MC Politi","year":"2020","unstructured":"Politi MC, Lee CN, Philpott-Streiff SE, Foraker RE, Olsen MA, Merrill C et al (2020) A randomized controlled trial evaluating the BREASTChoice tool for personalized decision support about breast reconstruction after mastectomy. 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J Huber reports grants and nonfinancial support from Intuitive Surgical and Coloplast outside the submitted work. Moreover, J Huber and C W\u00fclfing are members of the medical board of the Urological Foundation for Health. C Groeben reports fees from Janssen, Merck and Bayer outside the presented work. Elke Kessler is a managing director, Tobias Kessler is a deputy managing director and Marco Kn\u00f6ll is a partner of ASD Concepts GmbH & Co. KG. All the other authors report no disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"275"}}