A prospective cohort study of treatment decision-making for XXXX following participation in a multidisciplinary clinic.

@entity1 @entity263
BACKGROUND: @entity1 diagnosed with @entity263 ( @entity263 ) are presented with several treatment options of similar efficacy but varying side effects. Understanding how and why @entity1 make their treatment decisions, as well as the effect of treatment choice on long-term outcomes, is critical to ensuring effective, @entity1 -centered care. This study examined treatment decision-making in a racially diverse, equal-access, contemporary cohort of @entity1 with @entity263 counseled on treatment options at a multidisciplinary clinic. METHODS: A prospective cohort study was initiated at the Walter Reed National Military Medical Center (formerly Walter Reed Army Medical Center) in 2006. Newly diagnosed @entity1 with @entity263 were enrolled before attending a multidisciplinary clinic. @entity1 completed surveys preclinic and postclinic to assess treatment preferences, reasons for treatment choice, and decisional regret. RESULTS: As of January 2014, 925 @entity1 with @entity263 enrolled in this study. Surgery (54%), external radiation (20%), and active surveillance (12%) were the most common primary treatments for @entity1 with low- and intermediate-risk @entity263 , whereas @entity1 with high-risk @entity263 chose surgery (34%) or external radiation with neoadjuvant hormones (57%). Treatment choice differed by age at diagnosis, race, comorbidity status, and calendar year in both univariable and multivariable analyses. @entity1 preferred to play an active role in the decision-making process and cited doctors at the clinic as the most helpful source of treatment-related information. Almost all @entity1 reported satisfaction with their decision. CONCLUSIONS: This is one of the first prospective cohort studies to examine treatment decision-making in an equal-access, multidisciplinary clinic setting. Studies of this cohort would aid in understanding and improving the @entity263 decision-making process.
