Building a Digital Health Risk Calculator for Older Women with Early-Stage Breast Cancer

Thousands of older women diagnosed with early-stage breast cancer receive adjuvant radiation treatment therapy that can be safely omitted. The decision to undergo radiation treatment therapy is based upon several factors unique to the individual. Understanding the patient-specific relative risk and benefit of radiation therapy-and making the right decision for the patient's health-is a complex process that often fails to follow the shared-decision model between patient and clinician. The use of digital health tools to support and navigate complex and personalized healthcare focused decisions have been shown to increase patient comprehension and reduce decision-based conflict. In this paper we describe how we designed, developed, and tested an electronic, tablet-based decision aid tool to provide patient-specific, risk-benefit information with the goal of helping older women determine whether to receive radiation therapy. Our decision aid tool, Radiation for Older Women (ROW), utilizes user-centered design principles to facilitate evidence-based treatment decisions.