Using Decision Tools for Mesothelioma: Enhancing Shared Decision-Making

Mesothelioma, caused by asbestos exposure, is a rare and aggressive cancer. It often presents many challenges in diagnosis, treatment, and patient management. With advances in medical technology and data analytics, decision tools are becoming crucial for helping clinicians make informed decisions. 

A new article from the Society for Medical Decision-Making explores decision tools, how clinicians use them, and their role in enhancing shared decision-making for patients with mesothelioma.

What Are Decision Tools?

Decision tools are software or algorithms that help healthcare providers make clinical decisions by combining patient-specific data with evidence-based guidelines and predictive models. 

These tools analyze various factors, like medical history, clinical findings, and risk factors, to give recommendations or predict outcomes. They come in many forms, such as risk calculators, clinical decision support systems (CDSS), and tools used during patient consultations.

The Role of Decision Tools in Mesothelioma Management

For mesothelioma, decision tools can help in several key areas. In diagnosis, they can identify patients at risk based on their exposure history and symptoms. In staging, they determine the extent of the disease to guide treatment options. 

For treatment planning, they evaluate the benefits and risks of different treatments, including surgery, chemotherapy, radiation, and new therapies. In prognostication, they estimate survival rates and disease progression, helping inform patient discussions and care planning.

Enhancing Shared Decision Making (shared decision-making)

Shared decision-making is a collaborative process in which clinicians and patients collaborate to make healthcare decisions that align with the patient’s values, preferences, and goals. Decision tools enhance shared decision-making by providing personalized risk assessments and treatment outcomes, making complex medical information more understandable for patients.

A recent study looked at how primary care clinicians view the use of decision tools for lung cancer screening, which can also apply to mesothelioma. The study included 96 clinicians from various Veterans Affairs sites who shared their thoughts on using the DecisionPrecision tool for personalized lung cancer screening discussions.

The study found that clinician willingness to use the DecisionPrecision tool varied widely. Some were very enthusiastic, while others were definite non-adopters.

Many clinicians found using prediction models to personalize shared decision-making highly appealing. They saw the potential to improve patient outcomes and engagement by providing tailored information.

However, clinicians also identified several barriers to using these tools regularly. Time constraints during patient visits made using and explaining the tools difficult. To use the tools effectively, more training and familiarity were needed. Integrating the tools smoothly into clinical workflows and electronic health records (EHRs) was also challenging.

Strategies to Overcome Barriers

Several strategies can help facilitate the adoption of prediction-based shared decision-making tools in clinical practice. First, decision tools can be streamlined and integrated with EHR systems to minimize disruption to clinical workflows. Second, clinicians can be trained comprehensively to ensure they are comfortable and proficient in using the tools.

Third, designing tools that are quick and easy to use during patient consultations, possibly through pre-visit preparation. Lastly, patient education materials should be enhanced to support shared decision-making, ensuring patients understand the information provided by the tools.

Moving Forward

Decision tools have great potential to improve mesothelioma management by supporting personalized, evidence-based decisions. While many clinicians see their value, practical challenges must be addressed for effective use in routine practice. By overcoming barriers like time constraints, training, and workflow integration, decision tools can lead to better patient outcomes and more meaningful shared decision-making experiences.

As oncology continues to evolve, integrating decision tools into clinical practice will be crucial for advancing personalized medicine and improving the care of patients with mesothelioma and other complex cancers.

Source:

Skurla, Sarah E., N. Joseph Leishman, Angela Fagerlin, Renda Soylemez Wiener, Julie Lowery, and Tanner J. Caverly. “Clinician Perceptions on Using Decision Tools to Support Prediction-Based Shared Decision Making for Lung Cancer Screening.” MDM Policy & Practice 9, no. 1 (2024): 23814683241252786. https://doi.org/10.1177/23814683241252786.