Decision aids built into the record for every preference-sensitive cancer choice
Choices like mastectomy versus lumpectomy, or whether to have chemotherapy after surgery, depend on what matters to the patient. Good decision aids exist but are rarely used; building them into the clinic workflow would change that.
Decision aids improve knowledge, reduce decisional conflict, and often shift choices toward less intensive treatment in randomised trials, yet routine use is rare. Embedding validated aids into the electronic record so that they are triggered at the relevant decision point, pre-populated with the patient's own risk estimates, and documented as part of consent would make shared decision-making the default rather than an add-on.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
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