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Shared decision-making quality and decisional regret in patients with low-risk superficial basal cell carcinoma: A
Andrea Catalan-Griffiths1, Paola Pasquali2, Salvador Arias-Santiago3,4
1Dermatology Service, Medical University of Graz, Graz, Austria / AUVA Rehabilitation Clinic Tobelbad, Tobelbad, Austria.
Background:
Many therapies are available to treat low-risk superficial basal cell carcinoma (lr-sBCC), which may complicate the shared decision-making (SDM) process.
Objective:
To assess the SDM process of patients and physicians when deciding lr-sBCC therapy as well as the factors that may influence the SDM process.
Methods:
A prospective, multicenter cohort study was conducted over 18 months, from October 2018 to April 2020, in 3 tertiary university hospitals and 1 private hospital.
Results:
This study included 107 patients. There was a weak positive correlation between Shared Decision-Making Questionnaire-Patient version (SDM-Q-9) and Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) (Spearman's correlation coefficient [r] [105] = 0.21; P = .03). Most patients (71%) chose a nonsurgical treatment after the SDM process. Patients with higher satisfaction with the SDM had lower decisional conflict and decisional regret (P < .001). Patients aged >80 years had higher rates of significant decisional conflict. When evaluating treatment decisions, the highest median score for decisional conflict (22, IQR [16]; P = .01) was observed among patients who chose a surgical excision.
Limitations:
Patients may have self-selected to participate.
Conclusion:
This study suggests that some patients may prefer less invasive therapies for lr-sBCC. The SDM process may reduce decisional conflict and decisional regret.
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