{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:47:31Z","timestamp":1790347651225,"version":"4.1.0"},"reference-count":84,"publisher":"JMIR Publications Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due to the increasing use of shared decision-making, patients with esophagogastric cancer play an increasingly important role in the decision-making process. To be able to make well-informed decisions, patients need to be adequately informed about treatment options and their outcomes, namely survival, side effects or complications, and health-related quality of life. Web-based tools and training programs can aid physicians in this complex task. However, to date, none of these instruments are available for use in informing patients with esophagogastric cancer about treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to develop and evaluate the feasibility of using a web-based prediction tool and supporting communication skills training to improve how physicians inform patients with esophagogastric cancer about treatment outcomes. By improving the provision of treatment outcome information, we aim to stimulate the use of information that is evidence-based, precise, and personalized to patient and tumor characteristics and is communicated in a way that is tailored to individual information needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We designed a web-based, physician-assisted prediction tool\u2014Source\u2014to be used during consultations by using an iterative, user-centered approach. The accompanying communication skills training was developed based on specific learning objectives, literature, and expert opinions. The Source tool was tested in several rounds\u2014a face-to-face focus group with 6 patients and survivors, semistructured interviews with 5 patients, think-aloud sessions with 3 medical oncologists, and interviews with 6 field experts. In a final pilot study, the Source tool and training were tested as a combined intervention by 5 medical oncology fellows and 3 esophagogastric outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Source tool contains personalized prediction models and data from meta-analyses regarding survival, treatment side effects and complications, and health-related quality of life. The treatment outcomes were visualized in a patient-friendly manner by using pictographs and bar and line graphs. The communication skills training consisted of blended learning for clinicians comprising e-learning and 2 face-to-face sessions. Adjustments to improve both training and the Source tool were made according to feedback from all testing rounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Source tool and training could play an important role in informing patients with esophagogastric cancer about treatment outcomes in an evidence-based, precise, personalized, and tailored manner. The preliminary evaluation results are promising and provide valuable input for the further development and testing of both elements. However, the remaining uncertainty about treatment outcomes in patients and established habits in doctors, in addition to the varying trust in the prediction models, might influence the effectiveness of the tool and training in daily practice. We are currently conducting a multicenter clinical trial to investigate the impact that the combined tool and training have on the provision of information in the context of treatment decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/27824","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T18:54:22Z","timestamp":1621882462000},"page":"e27824","source":"Crossref","is-referenced-by-count":14,"title":["Informing Patients With Esophagogastric Cancer About Treatment Outcomes by Using a Web-Based Tool and Training: Development and Evaluation Study"],"prefix":"10.2196","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-4405","authenticated-orcid":false,"given":"Lo\u00efs F","family":"van de Water","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-834X","authenticated-orcid":false,"given":"H\u00e9ctor G","family":"van den Boorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-3015","authenticated-orcid":false,"given":"Florian","family":"Hoxha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3668-7495","authenticated-orcid":false,"given":"Inge","family":"Henselmans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9521-0577","authenticated-orcid":false,"given":"Mart M","family":"Calff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3728-6933","authenticated-orcid":false,"given":"Mirjam A G","family":"Sprangers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4324-7954","authenticated-orcid":false,"given":"Ameen","family":"Abu-Hanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8145-8595","authenticated-orcid":false,"given":"Ellen M A","family":"Smets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3546-9709","authenticated-orcid":false,"given":"Hanneke W M","family":"van Laarhoven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-017-0517-9"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112088"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw350"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw329"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11010080"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1601256"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw166"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-016-9632-2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz133"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7417.736"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.06.022"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11040530"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.132"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1999.00263.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-018-1308-x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X07307270"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.08.032"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.96.5.219"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0292"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2009.10.030"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/0037-7856(74)90107-3"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1995.13.7.1817"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/978-3-322-87859-5_10","author":"Good, M","year":"1991","journal-title":"Anthropologies of Medicine"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.2221"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2012.665476"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-012-1495-1"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1002\/pon.949"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-012-1450-7"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0042-8"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2003.10.008"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2011.12.004"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2017.05.012"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2004.30420.x"},{"key":"ref35","first-page":"1","author":"Jacobs, M","year":"2015","journal-title":"PhD thesis"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1137"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.4.980"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1186\/bcr2464"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192310"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1101\/2020.11.16.20232348"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1002\/pon.948"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000409"},{"issue":"2","key":"ref43","first-page":"106","volume":"57","author":"Kotter, JP","year":"1979","journal-title":"Harv Bus Rev"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1655"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.7631"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11020187"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.2219"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02503-8"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"NielsenJEnhancing the explanatory power of usability heuristicsProceedings of the SIGCHI Conference on Human Factors in Computing Systems1994CHI94: ACM Conference on Human Factors in Computer SystemsApril 24 - 28, 1994Boston Massachusetts USA1528","DOI":"10.1145\/191666.191729"},{"key":"ref50","first-page":"1","author":"Sommerville, I","year":"2016","journal-title":"Software Engineering 10th Edition (International Computer Science)"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1109\/TVCG.2016.2598588"},{"key":"ref52","author":"Brooke, J","year":"1996","journal-title":"Usability Evaluation In Industry"},{"key":"ref53","first-page":"1","author":"Snijders, T","year":"1994","journal-title":"Case Method Fast Track: A Rad Approach"},{"key":"ref54","first-page":"1","author":"Villanueva, R","year":"2016","journal-title":"ggplot2 : Elegant Graphics for Data Analysis"},{"key":"ref55","unstructured":"ChangWChengJAllaireJXieYMcPhersonJShiny: web application framework for RR Package Version 1.6.020172021-07-13https:\/\/cran.r-project.org\/web\/packages\/shiny\/index.html"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1177\/160940690900800301"},{"key":"ref57","unstructured":"Think-aloud demonstration videoGabor Aranyi PvSaPBoTU, UK (techslingtv)20122021-02-12https:\/\/www.youtube.com\/watch?v=BwpPIiBK0cA"},{"key":"ref58","unstructured":"KirschnerPvan Merri\u00ebnboerJJTen steps to complex learning : a new approach to instruction and instructional designCiteseer2021-07-13http:\/\/web.mit.edu\/xtalks\/TenStepsToComplexLearning-Kirschner-VanMerrienboer.pdf"},{"key":"ref59","first-page":"72","author":"Van Merrienboer, JJ","year":"2007","journal-title":"Trends and Issues in Instructional Design and Technology (2nd Ed.)"},{"key":"ref60","unstructured":"Van Merri\u00ebnboerJJKirschnerPAThree worlds of instructional design: state of the art and future directionsInstr Sci20012021-07-14https:\/\/dspace.library.uu.nl\/bitstream\/handle\/1874\/18840\/kirschner_01_three_worlds_instructional_design_state_art.pdf?sequence=1"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-017-3838-8"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.2311"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.2174"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2011.03.007"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0295"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2015.01.021"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.6016"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0090"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2004.22.90140.6098"},{"key":"ref70","unstructured":"ScottNFayersPAaronsonNBottomleyAde GraefAGroenvoldMGundyCKollerMPetersenMASprangersMAEORTC QLQ-C30 reference values manualEORTC Quality of Life Group20082021-07-14https:\/\/www.eortc.org\/app\/uploads\/sites\/2\/2018\/02\/reference_values_manual2008.pdf"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp564"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3445"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2419.2011.00373.x"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1027\/1618-3169.56.4.236"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1007\/BF01320097"},{"issue":"3","key":"ref76","first-page":"197","volume":"20","author":"Dempster, F","year":"1993","journal-title":"J Instr Psychol"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.84.5.795"},{"key":"ref78","unstructured":"MossVThe efficacy of massed versus distributed practice as a function of desired learning outcomes and grade level of the studentAll Graduate Theses and Dissertations - Utah State University19952021-07-14https:\/\/digitalcommons.usu.edu\/about.html"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1086\/374692"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12040834"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12566"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2020.103069"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00684"},{"key":"ref84","unstructured":"Source Tool20192021-02-12https:\/\/source.amc.nl\/"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2021\/8\/e27824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:40:18Z","timestamp":1782841218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2021\/8\/e27824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,27]]},"references-count":84,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/27824","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.27824","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,27]]}}}