Learn More
OBJECTIVE To examine the limits of the effectiveness of critical care through the study of patients for whom it was ineffective. DESIGN We studied the relationship between resource use and long-term outcome (2-year follow-up) in 402 consecutively admitted critical care patients to develop a benchmark for ineffective applications of critical care. We(More)
OBJECTIVE Does decision navigation (DN) increase prostate cancer patients' confidence and certainty in treatment decisions, while reducing regret associated with the decisions made? METHODS Two hundred eighty-nine newly diagnosed prostate cancer patients were eligible. 123 consented and were randomised to usual care (n = 60) or navigation (n = 63). The(More)
BACKGROUND Our purpose was to collect preliminary data on newly diagnosed breast cancer patient knowledge of prognosis before and after oncology visits. Many oncologists use a validated prognostic software model, Adjuvant!, to estimate 10-year recurrence and mortality outcomes for breast cancer local and adjuvant therapy. Some oncologists are printing(More)
PURPOSE Adjuvant! Online (www.adjuvantonline.org) is a software model that predicts the benefit of adjuvant therapy for women with early-stage breast cancer. The model has been validated, is widely consulted, and has been shown to influence patient choices in the clinical setting. Adjuvant! requires the clinician to input patient age, tumor size, grade,(More)
OBJECTIVE We examined the reach and impact of five decision aids (DAs) routinely distributed to breast cancer patients as part of a shared decision making demonstration project. METHODS From 2005 to 2008, we surveyed patients' change in knowledge and decisional conflict (DC) before and after their review of DAs. Using bivariate tests, we identified(More)
OBJECTIVE Decision Services (DS) provide support for breast cancer patients at the University of California, San Francisco to help ensure patient-centered care. METHODS We examined a case study to explore whether our program practices matched our program theory, and what the patient in the case thought was effective and ineffective about our decision(More)
The decentralized structure of health care in the Unites States hinders population-based analysis of breast cancer screening. Our objectives are to model mammography in the United States as a whole, to identify the variables that most profoundly affect cost and efficacy, and to develop a strategy to improve mammography screening from a population(More)
BACKGROUND Despite evidence that shared decision-making tools for treatment decisions improve decision quality and patient engagement, they are not commonly employed in orthopaedic practice. The purpose of this study was to evaluate the impact of decision and communication aids on patient knowledge, efficiency of decision making, treatment choice, and(More)
BACKGROUND The purpose of this paper is to examine the acceptability, feasibility, reliability and validity of a new decision quality instrument that assesses the extent to which patients are informed and receive treatments that match their goals. METHODS Cross-sectional mail survey of recent breast cancer survivors, providers and healthy controls and a(More)