# Exploring the MAPPING application to facilitate risk communication and shared decision-making between physicians and patients with gynaecological cancer

## TL;DR

This study explores how well doctors communicate cancer treatment risks to patients and how a new tool called MAPPING could help improve these conversations.

## Contribution

The study introduces the MAPPING application as a potential tool to enhance risk communication and shared decision-making in gynaecological cancer care.

## Key findings

- Patients were minimally involved in decision-making, with low OPTION-5 and RCC scores.
- Patients preferred numeric information, but physicians mostly used qualitative terms.
- Gynaecologists had a positive attitude toward MAPPING but suggested improvements in layout and implementation.

## Abstract

This is an observational study in which we evaluated current levels of risk communication (RC) among gynaecological oncologists and their view on the Mapping All Patient Probabilities in Numerical Graphs (MAPPING) application as a possible tool to facilitate RC and shared decision-making (SDM). In part A, we audio-recorded 29 conversations between gynaecological oncologists and patients when discussing treatment options. In part B, interviews were performed with eight gynaecological oncologists.

RC and SDM were measured using two observer-based measures, that is, the RC content (RCC) tool (scale 0–2) and the OPTION-5 instrument (scale 0–100). We used CollaboRATE questionnaire (scale 0–10) and a self-developed survey to assess patient-reported RC and SDM. In part B, we evaluated physicians’ attitudes regarding the use of the MAPPING application to support RC. Patients were minimally involved in the decision-making process (OPTION-5 25.9%±13.4 RCC 0.21±0.18). Patient-reported SDM was high (mean collaboRATE score 9.19±1.79) and patients preferred receiving numeric information, whereas most physicians used qualitative risk terms rather than exact numbers. In part B, gynaecologists had a positive attitude towards the MAPPING application. However, they stated that the app was difficult to use improvement of layout and better implementations are needed.