Can a digital tool improve the understanding of treatment option for patients with head/neck cancer and increase providers' self-perceived ability to communicate with patients?: Shortened Running Title: Digital tool for head/neck cancer treatment understanding.

Purpose: A digital visual communication tool was recently developed by MyCareGorithm which incorporates explanations of treatments and procedures for cancer patients. This study will evaluate if this novel tool can enhance both patient and provider satisfaction.

Methods: In an IRB approved, prospective, pilot study, patients and caregivers at a single institution receiving head and neck cancer radiation underwent an initial consult using this digital tool and completed a survey of 6 questions to evaluate their understanding of their disease. Providers completed a 7-question survey to rate their satisfaction. Patients and caregivers with 4 or more "Yes" answers and providers with 5 or more "Yes" answers were defined as "Satisfied". In order to obtain 90% power to detect that the proportion of "Satisfied" patients (assumed 75%) is greater than 50% with a significance level 5% using a one-sided Z test, we planned to enroll 30 patients.

Results: Thirty patients enrolled and completed all surveys. Most patients were male (66%), white (60%) and spoke English as a primary language (93%). Patients most commonly had oropharyngeal cancer (23%). Overall, 27 out of 30 of patients (90%; one sided 95%CI: 76.1%) were satisfied (z = 4.38, p < 0.05), 16 of the 17 caregivers (94%; one sided 95% CI: 74.8%) were satisfied and 100% of providers were satisfied with the digital tool. Most patients (90%) and caregivers (94%) felt that the tool improved their understanding of the disease. One male answered "No" for all 6 questions commenting that it was only marginally helpful. One female also answered "No" for all questions commenting that she did not find it helpful on its own without the provider explanation. Out of the 30 patients, 26 (87%) stayed at our institution to receive treatment.

Conclusions: These findings showed high rates of patient, caregiver and provider satisfaction with their initial consult when incorporating a digital visual tool. Its routine use in clinical practice should be strongly considered.