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Purpose: Fertility preservation (FP) is an important issue for young survivors of breast cancer. Although international guidelines recommend pre-treatment fertility counseling for women with breast cancer, there is no standardized protocol or referral system for FP in South Korea. There are also barriers to discussing FP that make patient-centered decision making difficult. This study aimed to develop a shared decision making program for FP and compare the rates of FP procedures between the usual care and shared decision making groups. We hypothesized that multidisciplinary shared decision making for FP would increase the rate of FP procedures and patient satisfaction.
Methods: The multidisciplinary shared decision making for FP in young women with breast cancer (MYBC) is a multicenter, clustered, stepped-wedge, randomized trial. A total of 1100 patients with breast cancer, aged 19-40 years, from nine hospitals in South Korea, will be enrolled. They will be randomized at the institutional level and assigned to usual care and shared decision making groups. Four institutions, each of which can recruit more than 200 patients, will each become a cluster, whereas five institutions, each of which can recruit more than 50 patients, will become one cluster, for a total of five clusters. The shared decision making groups will receive multidisciplinary programs for FP developed by the investigator. The primary outcome is the rate of FP procedures; secondary outcomes include fertility results, satisfaction, and quality of life. Outcomes will be measured at enrollment, treatment initiation, and the 1-, 3-, and 5-year follow-ups after starting breast cancer treatment.
Discussion: A multidisciplinary shared decision making program for FP is expected to increase fertility rates and satisfaction among young patients with breast cancer. This study will provide the evidence to implement a multidisciplinary system for patients with breast cancer.
Trial Registration: ClinicalTrials.gov Identifier: NCT05139641. Registered on December 1, 2021.
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http://dx.doi.org/10.4048/jbc.2023.26.e44 | DOI Listing |
J Med Internet Res
September 2025
School of Nursing, University of Minho, Braga, Portugal.
Background: The spread of misinformation on social media poses significant risks to public health and individual decision-making. Despite growing recognition of these threats, instruments that assess resilience to misinformation on social media, particularly among families who are central to making decisions on behalf of children, remain scarce.
Objective: This study aimed to develop and evaluate the psychometric properties of a novel instrument that measures resilience to misinformation in the context of social media among parents of school-age children.
Clin Orthop Relat Res
September 2025
Leni & Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Peripheral nerve injury commonly results in pain and long-term disability for patients. Recovery after in-continuity stretch or crush injury remains inherently unpredictable. However, surgical intervention yields the most favorable outcomes when performed shortly after injury.
View Article and Find Full Text PDFJAMA Cardiol
September 2025
Department of Medicine, Cardiovascular Medicine, Stanford University, Stanford, California.
Importance: Consumer wearable technologies have wide applications, including some that have US Food and Drug Administration clearance for health-related notifications. While wearable technologies may have premarket testing, validation, and safety evaluation as part of a regulatory authorization process, information on their postmarket use remains limited. The Stanford Center for Digital Health organized 2 pan-stakeholder think tank meetings to develop an organizing concept for empirical research on the postmarket evaluation of consumer-facing wearables.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Harvard Medical School, Boston, Massachusetts.
Importance: Research in behavioral economics has demonstrated that people have irrational biases, which make them susceptible to decisional shortcuts, or heuristics. The extent to which physicians consciously might use nudges to exploit these heuristics and thereby influence their patients' decision-making is unclear. In addition, ethical questions about the conscious use of nudges in medicine persist, yet little is known about how physicians experience and perceive their use.
View Article and Find Full Text PDFCult Health Sex
September 2025
Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
Transgender women and sex workers in Brazil underutilise HIV prevention services. Understanding preferences and decision-making regarding HIV prevention can help develop new programmes to meet their needs. We conducted semi-structured interviews with 26 transgender women and travesti sex workers in São Paulo, Brazil.
View Article and Find Full Text PDF