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Advancing Knowledge of Values-Clarification Processes During Complex Decision-Making Among Older Adults With Advanced

Amy C Cole1,2, Allison M Deal3, Angela M Stover3,4

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Summary

This pilot study evaluates how a values-clarification tool impacts shared decision-making (SDM) for older adults with advanced cancer. Findings will inform better alignment of cancer treatment decisions with patient values.

Keywords:
communicationhuman factorsoncologyshared decision-makingsimulationsvalues-clarification

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Area of Science:

  • Geriatric oncology
  • Shared decision-making
  • Patient values clarification

Background:

  • Older adults comprise the majority of US cancer diagnoses, facing complex treatment decisions balancing survival and quality of life.
  • Shared decision-making (SDM) is emphasized, yet patient-reported guidance often fails to align with personal values.
  • Values-clarification tools show modest improvements, but their impact on decision-making processes requires further study.

Purpose of the Study:

  • To estimate the quality of values-clarification and SDM processes in simulated advanced cancer diagnosis encounters.
  • To compare these processes between older adult participants who receive a values-clarification tool versus a general communication guide.

Main Methods:

  • Pilot randomized study with simulated patient-clinician encounters for individuals aged 60+ with advanced cancer.
  • Intervention group received the Values and Outcomes to Improve Cancer Experiences (VOICE) tool; control group received an American Cancer Society (ACS) guide.
  • Evaluated values elicitation, processing, and integration using the VECTORS rating scale, OPTION-5, CollaboRATE, and PrepDM, supplemented by qualitative interviews.

Main Results:

  • The study enrolled 44 participants between September and December 2024.
  • Data collection is complete, and the study is prepared for analysis.

Conclusions:

  • This pilot study will offer preliminary insights into the quality of values-clarification during patient-clinician interactions for older adults with advanced cancer.
  • Findings aim to enhance the integration of patient values into complex cancer treatment decisions.