Decision Aids for Patients Considering Options Affecting Cancer Outcomes: Evidence of Efficacy and Policy Implications

Some cancer screening and treatment decisions are not clear cut because outcomes are uncertain or options have different benefit/risk profiles. “Decision aids ” have been developed as adjuncts to counseling so that patients can learn about ben-efits and risks, can consider their personal values, and can participate with their practitioner in decision making. The purpose of this paper is to review published evidence about the efficacy of decision aids focused on cancer outcomes and to outline research and dissemination issues. Studies evalu-ating cancer-related decision aids demonstrate that they are acceptable to patients and help those who are uncertain at baseline to make choices. They also increase the likelihood that choices are based on better knowledge, realistic expec-tations of outcomes, and personal values. Decision aids re-duce some dimensions of decisional conflict, and their effec