Surgery or Non-invasive Treatment for Superficial Basal Cell Carcinoma: Does a Patient Decision Aid Help to Make a Personalized Treatment Decision?

Abstract

Patients with a superficial basal cell carcinoma can be treated surgically or non-invasively, all with specific (dis)advantages. An investigation was undertaken into whether the preference for surgery or non-invasive treatment of a superficial basal cell carcinoma differs between patients who used a patient decision aid and a control group. Secondly, whether patients were satisfied with their decision post-treatment was investigated. A prospective observational study was performed comparing patients with a superficial basal cell carcinoma who used a patient decision aid (patient decision aid group) with a control group. The primary outcome was the proportion of patients that chose non-invasive treatment. A secondary outcome was the mean score of "effective decision-making" on the Decisional Conflict Scale 3 months post-treatment. In the patient decision aid group, 48.6% (52/109) seemed to prefer non-invasive treatment vs 40.8% (42/103) in the control group (p = 0.255); the result was not significant. Three months post-treatment, the adjusted between-group mean difference in "effective decision-making" was -4.10 (p = 0.082) favouring the patient decision aid group (effect size 0.3). To conclude, patients who used a patient decision aid seemed to choose non-invasive therapy over surgery slightly more often but the result was not significant.