Related Experiment Video
Updated: Jun 6, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Improved Shared Decision-making for Patients with Renal Cell Carcinoma: Results of the SDM-RCC Study
Cato C Bresser1, Mirjam M Garvelink2, Tessa van Dijk3
1Department of Urology, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands; Department of Value Improvement, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands; Radboudumc, IQ Health, Nijmegen, The Netherlands.
Background And Objective:
To improve shared decision-making (SDM) for renal cell carcinoma (RCC), we implemented an SDM intervention consisting of a patient decision aid and health care professional (HCP) training. This study evaluates its effectiveness.
Design, Setting, And Parcticipants:
Multicenter prospective pretest-post-test study including adults with localized RCC or metastatic clear cell RCC. The pretest group received standard care; the post-test group was included after SDM intervention implementation.
Outcome Measurement And Statistical Analysis:
The primary outcome was the Observing Patient Involvement in Decision-making (OPTION)-5 score, measuring patient involvement. Secondary outcomes included HCP- and patient-reported SDM and decision quality (eg, Decisional Conflict Scale [DCS], Control Preference Scale [CPS]). Exploratory outcomes were quality of life, quality of the decision-making process (ie, Assessing Communication about Evidence and Patient Preferences [ACEPP] subscale 1A), and process indicators (eg, treatment decision). Mixed-effects regression model with random intercepts for hospital was used.
Results And Limitations:
Post-test, OPTION-5 scores increased significantly (47.2-60.5; mean difference 13.2; 95% CI [8.7-17.8]; p < 0.001), with improvements across most hospitals and all OPTION-5 items. HCP-reported SDM and ACEPP subscale 1A also increased (both p < 0.001), while patient-reported SDM remained unchanged. The number and duration of consultations increased, and DCS uncertainty scores showed more conflict, while the CPS remained unchanged. The pretest-post-test design minimized inter-hospital workflow variation and supported sustained behavioral change but limits causal inference.
Conclusions:
Implementation of an SDM intervention was significantly associated with observed and HCP-reported SDM, while patient-perceived involvement remained similar. These findings suggest integrating the SDM intervention into routine RCC care to promote patient-centered decision-making.
