Toward personalized shared decision-making: a pilot study on an individualized patient decision aid

Abstract

Decision aids are tools that can reduce decisional conflict and enhance patient satisfaction in the decision-making process. However, tool heterogeneity and clinical barriers, such as physician time constraints, hinder their implementation. This study introduces an individualized patient decision aid, developed within the European I3LUNG project, to support shared decision-making (SDM) in non-small cell lung cancer. The present decision aid is a dynamic, online tool structured into five sections (overview, prognosis/treatments, comprehension quizzes, patient preferences, and support/FAQs) designed to improve communication and emotional regulation between physicians and patients. The tool was evaluated using focus groups with patients and oncologists, interviews, thinking-out-loud sessions, and an ad hoc 32-item questionnaire. Focus groups and semi-structured interviews highlighted patient anxiety and oncologist interest in streamlining consultations and managing distress. Thinking-out-loud sessions confirmed that the decision aid may serve as an effective clinical guide. In the questionnaire, patients reported high overall satisfaction, demonstrating its clarity and clinical feasibility. The present decision aid may represent an innovative digital tool to promote SDM by aligning healthcare decisions with patient preferences, engaging caregivers at home, and reducing clinician cognitive workload and burnout. Future longitudinal, cross-cultural research integrating artificial intelligence and advanced human factors will be essential to provide more equitable and effective decision support. While preparing this manuscript, we partnered actively with non-small lung cancer patients and oncologists, with whom we had regular interactions to get their valuable and insightful input in shaping our reflections.