by Amy Zhao, Maya Larbi, Kristen Miller, Suzanne O'Neill,
Jinani Jayasekera
The Breast: VOLUME 61, P43-57, FEBRUARY
01, 2022 (Published: December 05, 2021)
The increasing attention on personalized breast cancer care
has resulted in an explosion of new interactive, tailored, web-based clinical
decision tools for guiding treatment decisions in clinical practice. The goal
of this study was to review, compare, and discuss the clinical implications of
current tools, and highlight future directions for tools aiming to improve
personalized breast cancer care. We searched PubMed, Embase, PsychInfo,
Cochrane Database of Systematic Reviews, Web of Science, and Scopus to identify
web-based decision tools addressing breast cancer treatment decisions. There
was a total of 17 articles associated with 21 unique tools supporting decisions
related to surgery, radiation therapy, hormonal therapy, bisphosphonates,
HER2-targeted therapy, and chemotherapy. The quality of the tools was assessed
using the International Patient Decision Aid Standard instrument. Overall, the
tools considered clinical (e.g., age) and tumor characteristics (e.g., grade)
to provide personalized outcomes (e.g., survival) associated with various
treatment options. Fewer tools provided the adverse effects of the selected
treatment. Only one tool was field-tested with patients, and none were tested
with healthcare providers. Future studies need to assess the feasibility,
usability, acceptability, as well as the effects of personalized web-based
decision tools on communication and decision making from the patient and
clinician perspectives.
