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OBJECTIVE To develop a set of quality criteria for patient decision support technologies (decision aids). DESIGN AND SETTING Two stage web based Delphi process using online rating process to enable international collaboration. PARTICIPANTS Individuals from four stakeholder groups (researchers, practitioners, patients, policy makers) representing 14(More)
PURPOSE Most women with breast cancer are diagnosed at an early stage and more than 80% will be long-term survivors. Routine follow-up marks the transition from intensive treatment to survivorship. It is usual practice for routine follow-up to take place in specialist clinics. This study tested the hypothesis that follow-up by the patient's family physician(More)
PURPOSE Physicians are urged to practice shared treatment decision making (STDM), yet this concept is poorly understood. We developed a conceptual framework describing essential characteristics of a shared approach. This study assessed the degree of congruence in the meanings of STDM as described in the framework and as perceived by practicing physicians.(More)
PURPOSE Because of its morbidity and chronicity, arm lymphedema remains a concerning complication of breast cancer treatment. Although massage-based decongestive therapy is often recommended, randomized trials have not consistently demonstrated benefit over more conservative measures. PATIENTS AND METHODS Women previously treated for breast cancer with(More)
BACKGROUND Physicians are increasingly urged to practice shared decision-making with their patients. Using a cross-sectional survey, we explored the extent to which Ontario breast cancer specialists report practising shared decision-making with their patients, their comfort level with this approach, and perceived barriers and facilitators to implementation.(More)
CONTEXT The development of trastuzumab has led to new therapeutic strategies for patients with breast cancer. Trastuzumab has been shown to only be effective in those patients whose cancers are HER2 positive by either immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH). OBJECTIVE To determine the accuracy of HER2 testing in 2 provinces(More)
OBJECTIVES To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids). DESIGN Scale development study, involving construct, item and scale development, validation and reliability testing. SETTING There has been increasing use of decision support(More)
BACKGROUND In the last 10 years, there has been a major growth in the development of treatment decision aids. Multiple goals have been identified for these tools. However, the rationale for and meaning of these goals at the conceptual level, the mechanisms through which decision aids are intended to achieve these goals, and value assumptions underlying the(More)
BACKGROUND Treatment with an aromatase inhibitor for 5 years as up-front monotherapy or after tamoxifen therapy is the treatment of choice for hormone-receptor-positive early breast cancer in postmenopausal women. Extending treatment with an aromatase inhibitor to 10 years may further reduce the risk of breast-cancer recurrence. METHODS We conducted a(More)
OBJECTIVE In this paper we discuss the influence of culture on the process of treatment decision-making, and in particular, shared treatment decision-making in the physician-patient encounter. We explore two key issues: (1) the meaning of culture and the ways that it can affect treatment decision-making; (2) cultural issues and assumptions underlying the(More)