Cardiff head and neck cancer: developing short decision support tools

Cardiff and Vale University Health Board

  • This project was run by Cardiff and Vale University Health Board.
  • It was run by the head and neck cancer team in Cardiff.
  • The team set out to enable patients to take part in active decision making through the use of decision support tools.
  • They agreed priority areas, appointed clinical experts, and developed draft option grids to share with patients for feedback.

Patients who use decision support tools have been shown to be more informed and able to take part in active decision making. Cardiff’s head and neck cancer team were particularly interested in using decision support tools. When they found none were suitable for their needs they decided to develop their own. 

They created ‘option grids’ – brief list-based tools, designed for clinical encounters. Information about the key features, benefits and risks of treatments, and questions for patients, are organised in a table for rapid access and comparison.

The team met and agreed three priority areas: early cancer of the tonsil, early cancer of the vocal cords and cancer of the voice box.

A clinical editor was appointed for each area, and small groups of clinical experts from surgery and oncology formed to collect evidence-based information on treatment options. Draft option grids were shared with the wider clinical team for discussion and patients are now being asked for their feedback.

The team’s involvement in the development process has:

  • enabled a team-based understanding of shared decision making
  • increased awareness of the importance of presenting treatment options
  • standardised how treatment options are verbally presented
  • aided the development of tools for local situations
  • given teams a sense of ownership
  • increased discussion about reasonable treatment options and the evidence (or lack of evidence) about likely risks and benefits of options
  • led to further discussion about how shared decision making can be part of a strong professionally oriented multidisciplinary team.

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