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Development of a goal elicitation measure to support bladder cancer patients’ choice about urinary diversion

ABSTRACT:Purpose:Patient-centered care aims to align treatment with patient goals, especially when treatment options have equivalent clinical outcomes. For surgeries with lasting impacts, that alignment is critical. No psychometrically tested preference-elicitation measures exist to support patients with bladder cancer undergoing cystectomy, who can often choose between ileal conduit and neobladder diversions. Our study created a scale to measure how patients’ goals align with each type of urinary diversion and their associated surgical outcomes.Materials and Methods:We conducted formative research through focus groups and clinician outreach to adapt a goal dissonance measure. We mailed a survey to adult Kaiser Permanente members who underwent cystectomy for bladder cancer between January 2013 and June 2015. Eligible patients were identified through electronic health records and chart review. Surveys were mailed 5-7 months post-surgery. We administered our 10-item, decision dissonance scale along with oth...