Exploring Shared Decision-Making | 77 3 Methods This prospective cross-sectional study was conducted according to the principles of the Declaration of Helsinki at the Department of Head and Neck Oncology and Surgery at a Dutch tertiary hospital [35]. The ethical review committee approved the study (registration number IRBd21-078). The research design, data collection process, and anticipated analyses were preregistered on the Open Science Framework (OSF; https://osf.io/248fu/). Participants and procedure We recruited five out of ten experienced HN surgeons based on age and gender to form a representative group within the Head and Neck department. Inclusion criteria were: 1) performing clinical work for more than three days per week; 2) having a permanent position as HN surgeon; and 3) having treatment decision-making consultations with non-cutaneous carcinoma HNC patients. Surgeons involved in the study setup were excluded as potential participants (RD, MvdB). To be eligible for the study, patients had to 1) be diagnosed with a primary non-cutaneous HNC; 2) be eighteen years or older; 3) have sufficient command of the Dutch language, and 4) no cognitive impairments (e.g., Korsakov syndrome). Patients were screened by the multidisciplinary tumor board, and then contacted by one of the researchers (AH or SD) to be informed about the study. Interested patients were seen before consultation for a face-to-face explanation of the study and the opportunity to ask questions, after which they signed informed consent. Between May 2021 and October 2022, consultations between surgeons, patients, and if present, their caregivers were recorded with a Roland Ediroll R-0736. During these consultations, diagnosis and advice for treatment from the multidisciplinary tumor board were discussed. Following up on previous studies33, 34, 37-41, we aimed to obtain at least five recordings per surgeon. Measures Patients’ age, gender, and diagnosis were collected from their electronic health record. Other characteristics, such as marital status, living situation, education level, employment status, and presence of an informal caregiver, were obtained after consultation via a study specific questionnaire that included the Dutch version of the SDM-Q-9 for patients and the Control Preference Scale (CPS)42. Likewise, after consultation, HN surgeons completed a similar study specific questionnaire, including questions about their work experience in Head and Neck oncology (in years), training in SDM (none, minimal= attended at least one course/training, some= attended > 2 courses/trainings), the SDM-Q-Doc for healthcare providers, and an adjusted CPS to fit surgeons’ perspective.
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