The development of a decision aid for patients with operable oropharyngeal carcinoma in the Netherlands - A mixed methods study

Anne N Heirman, Richard Dirven, Lisette van der Molen, Willem H Schreuder, Frank Hoebers, Jimmie Honings, Abrahim Al-Mamgani, Remco de Bree, Simone E J Eerenstein, Gyorgy B Halmos, Michiel W M van den Brekel

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OBJECTIVE: The aim of this project is to create an interactive online patient decision aid (PDA) for oropharyngeal cancer (OPSCC) patients, eligible for transoral (robotic) surgery with an ultimate goal to assist both physicians and patients in making treatment choices.

MATERIALS AND METHODS: Following the International Patient Decision Aid Standards, a mixed-methods approach was employed. The study involved semi-structured in-depth interviews with patients and physicians, thinking-out-loud sessions, and study-specific questionnaires. Thematic coding and analysis were conducted on verbatim transcriptions of audio-recorded interviews.

RESULTS: The PDA drafts were evaluated by twenty OPSCC survivors and twenty multidisciplinary specialists. Significant revisions were made after phase 1 to enhance readability and reduce text, whilst incorporating videos and graphics. Following all phases, both patients and specialists rated the PDA as comprehensible, feasible, and a valuable addition to regular counseling.

CONCLUSION: This study showcases the development of a PDA for early stage oropharyngeal cancer patients considering surgery and radiotherapy options. The decision aid emphasizes the disparities in short- and long-term side effects between the two treatments. Patients and physicians found the decision aid to be understandable, user-friendly, and helpful for future patients. The PDA is available on

Original languageEnglish
Article number106677
JournalOral Oncology
Early online date23 Dec 2023
Publication statusPublished - Feb 2024


  • Communication
  • Counseling
  • Head and neck cancer
  • Human
  • Oropharyngeal cancer
  • Papilloma
  • Shared decision-making
  • Virus


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