{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:30:44Z","timestamp":1777408244483,"version":"3.51.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A shared decision-making model is preferred for engaging prostate cancer patients in treatment decisions. However, the process of assessing an individual\u2019s preferences and values is challenging and not formalized. The purpose of this study is to develop an automated decision aid for patient-centric treatment decision-making using decision analysis, preference thresholds and value elicitations to maximize the compatibility between a patient\u2019s treatment expectations and outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A template for patient-centric medical decision-making was constructed. The inputs included prostate cancer risk group, pre-treatment health state, treatment alternatives (primarily focused on radiation in this model), side effects (erectile dysfunction, urinary incontinence, nocturia and bowel incontinence), and treatment success (5-year freedom from biochemical failure). A linear additive value function was used to combine the values for each attribute (side effects, success and the alternatives) into a value for all prospects. The patient-reported toxicity probabilities were derived from phase II and III trials. The probabilities are conditioned on the starting state for each of the side effects. Toxicity matrices for erectile dysfunction, urinary incontinence, nocturia and bowel incontinence were created for the treatment alternatives. Toxicity probability thresholds were obtained by identifying the patient\u2019s maximum acceptable threshold for each of the side effects. Results are represented as a visual. R and Rstudio were used to perform analyses, and R Shiny for application creation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We developed a web-based decision aid. Based on preliminary use of the application, every treatment alternative could be the best choice for a decision maker with a particular set of preferences. This result implies that no treatment has determinist dominance over the remaining treatments and that a preference-based approach can help patients through their decision-making process, potentially affecting compliance with treatment, tolerance of side effects and satisfaction with the decision.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We present a unique patient-centric prostate cancer treatment decision aid that systematically assesses and incorporates a patient\u2019s preferences and values to rank treatment options by likelihood of achieving the preferred outcome. This application enables the practice and study of personalized medicine. This model can be expanded to include additional inputs, such as genomics, as well as competing, concurrent or sequential therapies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-021-01732-2","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T16:02:58Z","timestamp":1640966578000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A personalized decision aid for prostate cancer shared decision making"],"prefix":"10.1186","volume":"21","author":[{"given":"Hilary P.","family":"Bagshaw","sequence":"first","affiliation":[]},{"given":"Alejandro","family":"Martinez","sequence":"additional","affiliation":[]},{"given":"Nastaran","family":"Heidari","sequence":"additional","affiliation":[]},{"given":"David","family":"Scheinker","sequence":"additional","affiliation":[]},{"given":"Alan","family":"Pollack","sequence":"additional","affiliation":[]},{"given":"Radka","family":"Stoyanova","sequence":"additional","affiliation":[]},{"given":"Eric","family":"Horwitz","sequence":"additional","affiliation":[]},{"given":"Gerard","family":"Morton","sequence":"additional","affiliation":[]},{"given":"Amar U.","family":"Kishan","sequence":"additional","affiliation":[]},{"given":"Mark K.","family":"Buyyounouski","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"1732_CR1","unstructured":"Society AC. \u201cProstate Cancer\u201d 2020. https:\/\/www.cancer.org\/cancer\/prostate-cancer.html."},{"key":"1732_CR2","first-page":"CD001431","volume":"4","author":"D Stacey","year":"2017","unstructured":"Stacey D, Legare F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4:CD001431.","journal-title":"Cochrane Database Syst Rev"},{"key":"1732_CR3","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.urology.2019.06.032","volume":"132","author":"A Pena","year":"2019","unstructured":"Pena A, Qian Z, Lambrechts S, Cabri JN, Weiser C, Liu H, et al. Evaluation of implementation outcomes after initiation of a shared decision-making program for men with prostate cancer. Urology. 2019;132:94\u2013100.","journal-title":"Urology"},{"issue":"9","key":"1732_CR4","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1001\/jamainternmed.2017.1923","volume":"177","author":"G Elwyn","year":"2017","unstructured":"Elwyn G, Cochran N, Pignone M. Shared decision making-the importance of diagnosing preferences. 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The approved protocol identification number is 48294. There was no human subject involvement and therefore consent was not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"374"}}