Effect of a Skills Training for Oncologists and a Patient Communication Aid on Shared Decision Making About Palliative Systemic Treatment: A Randomized Clinical Trial

The Oncologist 2020;25:e578–e588; first published on November 26, 2019; doi: 10.1634/theoncologist.2019-0453

The authors regret that there is an error in the results reflecting the effect of the interventions on patient-reported decisional conflict post-consultation.

We used the Dutch version of the Decisional Conflict Scale (DCS) as translated and validated by Koedoot and colleagues in 2001 [1]. This Dutch version was based on the DCS published in 1995 [2]; however, this version appears different from the version presented in the current manual of the DCS, first published in 1993 but updated in 2010 [3]. The item content is comparable, yet the version we used contains five items that need to be reverse coded. We calculated sum scores in accordance with the current manual and, hence, did not reverse code any of the items. This resulted in incorrect sum scores.

The corrected results are presented in Tables 2 and 3, shown here and corresponding to the numbered tables in the original article. On page e584 of the original article, the correct figures should be described as follows:

Condition did not affect patients’ decisional conflict (F(3,145) = 1.99, p = .12).

Table 2. Raw means with standard deviations of decisional conflict for total sample and each condition Outcomes N Raw means (SD) Full sample No physician training Physician training No patient aid Patient aid No patient aid Patient aid Patient decisional conflict (0–100) a 145 26.11 (15.04) 25.29 (12.96) 30.07 (18.26) 22.91 (14.24) 25.95 (13.47) a Patients were instructed to skip the items of the Decisional Conflict Scale if, in their view, a decision was not or not yet made (n = 23 patients skipped all or > 2 items of the scale). Table 3. Bootstrapped parameter estimates and 95% CIs of the fixed effects in the Mixed Linear Model Outcomes Training Communication aid Combination b (95% CI) Cohen's da b (95% CI) Cohen's da b (95% CI) Cohen's da Patient decisional conflict (0–100) –1.33 (–8.39–5.17) 0.09 6.36 (–0.75–13.85) 0.44 0.05 (–6.83–6.51) 0.00 a Difference in estimated marginal means (‘no training, no aid’ concerns the comparison group) divided by the pooled standard deviation calculated from the standard errors √(((se1 * √n1)2 * (n1-1) + (se2 * √n2)2 * (n2-1)/(n1+n2-2)).

The corrected results did not affect any of the conclusions of our study. Nevertheless, the authors would like to apologize for any inconvenience caused.

References

1. Koedoot N, Molenaar S, Oosterveld P et al. The decisional conflict scale: Further validation in two samples of Dutch oncology patients. Patient Educ Couns 2001;45:187-193.

2. O'Connor AM. Validation of a decisional conflict scale. Med Decis Making 1995;15:25-30.

3. O'Connor AM. User manual Decisional Conflict Scale 2010. Available from https://decisionaid.ohri.ca/docs/develop/User_Manuals/UM_decisional_conflict.pdf

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