PDA Impact in Advanced Larynx Cancer | 131 5 Results Participants In total, 128 eligible patients were approached, of which 91 patients (usual care arm n=45, intervention arm n=46) were included and returned the informed consent and questionnaires (participation rate 71.1%). Most patients were male, had a supraglottic tumor, a lower educational level, were retired and almost all had access to internet. Although there were no significant differences between the two study arms, there were some potentially clinically relevant differences. There were more advanced stages in the usual care arm, and the educational level was lower in the intervention arm. See table 1 for all characteristics. Figure 2 shows the flow of patients through the study and reasons for loss to follow-up. N=35 and N=39 physician questionnaires were available for T1 and T2, respectively. Decisional Conflict Median total DC score in the usual care arm was 73.44 (range 0-100), in the intervention arm 35.94 (range (17.19-46.88). After correcting for minor case mix differences via propensity score correction, the adjusted mean difference was -32.3 (bootstrapped 95%CI: -37.4; -26.1, p<0.001). Significant lower DC was also seen in the total score of the DCS at T2, with an adjusted mean difference of -38.0 (bootstrapped 95%CI -50.1, -24.2, p <0.001). Table 2 lists total and subscale scores. Almost all patients who participated in the usual care arm (44/45, 98%) experienced clinically significant DC (CSDC, DCS > 25), compared to 89% (41/46) in the intervention arm (adjusted OR 0.25, 95%CI 0.01; 1.9) p=0.238). Six months after treatment, 92% (23/25) of the patients in the usual care group still experienced CSDC, while in the intervention arm this 56.7% (17/30); adjusted OR 0.10 (95%CI 0.02 ; 0.44, p=0.005). Knowledge Test At T1, the intervention group exhibited significantly higher overall knowledge (median 75% correct) compared to the usual care group (median 45% correct). Knowledge is statistically significantly better in the intervention arm, with an average of 4.8 (95%CI 3.2, 6.6, P<0.001) percent point more correct. At T2 we saw similar patterns, although not significant. Knowledge was higher in the intervention group with 6.4 percent point more correct (95%CI 1,2, 27.0, P=0.07)
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