INTRODUCTION: Little is known about how physicians present diagnosis and treatment planning in routine practice in preference-sensitive treatment decisions. We evaluated completeness and quality of informed decision making in @entity263 post biopsy encounters. METHODS: We analyzed audio-recorded office visits of 252 @entity1 with presumed @entity263 (Gleason 6 and Gleason 7 scores) who were seeing 45 physicians at 4 Veterans Affairs Medical Centers. Data were collected between September 2008 and May 2012 in a trial of 2 decision aids (DAs). Braddock's previously validated @entity5516 ( @entity5516 ) system was used to measure quality. Latent variable models for ordinal data examined the relationship of @entity5516 score to treatment received. RESULTS: Mean @entity5516 score showed modest quality (7.61  2.45 out of 18) and high variability. Treatment choice and risks and benefits were discussed in approximately 95% of encounters. However, in more than one-third of encounters, physicians provided a partial set of treatment options and omitted surveillance as a choice. Informing quality was greater in @entity1 treated with surveillance (b = 1.1, p = .04). Gleason score (7 vs 6) and lower age were often cited as reasons to exclude surveillance. @entity1 preferences were elicited in the majority of cases, but not used to guide treatment planning. Encounter time was modestly correlated with @entity5516 score (r = 0.237, p = .01). DA type was not associated with @entity5516 score. DISCUSSION: Physicians informed @entity1 of options and risks and benefits, but infrequently engaged @entity1 in core shared decision-making processes. Despite @entity1 having received DAs, physicians rarely provided an opportunity for preference-driven decision making. More attention to the underused @entity1 decision-making and engagement elements could result in improved shared decision making.

@entity5516 : Assessment of the Quality of Physician Communication about XXXX Diagnosis and Treatment.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient', 'men'] @entity5516 :: ('MESH:D020195', 'Disease') :: ['IDM', 'Informed Decision Making'] @entity263 :: ('MESH:D011471', 'Disease') :: ['localized prostate cancer']
@entity263 :: (MESH:D011471,Disease) :: ['Prostate Cancer']
