Introducing PrefCoRe

Abstract

Background: Clinical complete response (cCR) may occur in rectal tumours after chemo‐radiotherapy (CRT), with some patients opting for ‘watch and wait’ (W&W), avoiding surgery. Despite initial nervousness, recent studies have shown this approach is oncologically safe. However, research addressing patient preferences or patient decision making is lacking. Moreover, there is no patient decision aid (PtDA) to assist individuals facing this choice. Yet, PtDAs have a positive effect on patient‐clinician communication and enhance patient decision‐making. As W&W is likely to be included in updated NICE guidelines, there is an imminent need to address this. Aims: 1Understand factors considered by patients during rectal cancer treatment decisions2Develop a user‐friendly PtDA informed by these factors3Conduct tests of the tool to determine acceptability and validity Method: This study is a collaboration between clinicians; health economists with discrete choice experiment (DCE) expertise; PtDA specialists; and patient and public involvement (PPI). Over 2 years (2020–22), led by a Health Economist researcher, we will undertake three workstreams (WS): WS1: An online DCE survey establishing preferences for surgery alone versus CRT then surgery; and where cCR occurs, W&W versus surgery, by presenting hypothetical treatment scenarios, with scope to sample 600 participants. WS2: Translate the DCE information to build an animated web‐based PtDA. WS3: Test the PtDA usability, utilising eye‐tracking and System Usability Scales, working with clinical patterns to identify its position in treatment pathways. Pilot Results: 48 PPI members were consulted on treatment preferences, resulting in mixed views, highlighting the need for this research.