3586 - RADAR -- A Novel Tool in Shared Decision-Making for Men with Prostate Cancer

Purpose/Objective(s): Treatment options for localized prostate cancer have similar survival and recurrence outcomes but come with different side-effect profiles, vary in time commitment, and may require additional hormone medication. With this in mind, patients may feel overwhelmed by the volume of information presented and needed to make an educated and values-concordant decision. Oncologists must participate in shared decision-making (SDM) with patients to ensure information is communicated and the patient’s values are acknowledged. Here, we implement a novel feedback tool, RADAR, to evaluate oncologists' and patients’ perceptions of the SDM conversation occurring during their visit to our institution’s multidisciplinary urology clinic (MDUC). Using RADAR, we aim to identify discrepancies in communication domains, provide real-time feedback to oncologists, and evaluate for misalignment patterns.

Materials/Methods: Participants are seen by a radiation oncologist and a urologic oncologist at the MDUC clinic. At the end of the encounter, patients receive a 10-question survey adapted from the Shared Decision-Making Questionnaire (SDM-Q-9). Providers are asked to complete a parallel survey that clinic day. Once all surveys are complete for an encounter, RADAR combines the data and graphically presents the alignment for all survey questions and communication domains.

Results: The study is ongoing and will be completed by ASTRO 2025. So far, 79 patients have been surveyed, however, only 69 patients have a RADAR output generated due to incomplete oncologists’ survey data. Misalignment in communication domains is determined by the difference between responder answers. 49/69 outputs are well aligned with no specific domain discrepancy. The domains with the most misalignment are “deliberating on options” (n = 8) and “exchanging information” (n = 5). In those cases, participants expressed they were not asked what was important to them during treatment, nor were they asked which treatment option they preferred. Overall, patients felt that treatment options were thoroughly discussed and all of their questions were answered. Additionally, most cases of misalignment were led by patient differences (n = 13/20).

Conclusion: We demonstrate a novel feedback tool in a multidisciplinary team setting, specifically for prostate cancer patients. We show that implementation in a fast-paced clinical setting can be difficult for real-time feedback, and debriefing may be easier at the end of the clinic day. Preliminary areas of improvement in communication skills focus on physicians deliberately asking patients about their values and preferences. At the end of most encounters, the next steps were generally additional workup or further deliberation at home, suggesting that physicians’ goals may be to provide information at initial visits rather than focusing on decision-making. With most cases of misalignment being patient-led, there may be some physician bias while reflecting on their communication skills.