A critical issue for knowledge exchange and transfer is how best to inform patients so they can make the most well informed choices concerning their treatment alternatives particularly when faced with serious or life threatening medical conditions.
The example of treatment for breast cancer is used to demonstrate knowledge exchange and transfer issues relevant to patients. Some barriers to knowledge exchange and transfer are discussed:
- understanding the language and jargon of biopsy reports
- acquiring adequate knowledge given the speed with which the patient needs to make a decision concerning initial surgical and follow up interventions
- the currency of information provided in the information sheets and booklets provided and on the web
- understanding of the pros and cons of alternative interventions
- the weighting given to relevant pieces of information
- finding critical pieces of information relevant to decision making
- obtaining timely information concerning breast reconstruction in the case of mastectomy
Most of these issues remain critical throughout one's treatment for cancer (and indeed for many other health conditions) but another very critical element for the patient is:
• Knowing the right questions to ask
This paper provides some examples concerning information that is relevant to patient decision making; questions about these issues may not be asked by patients and this information may not be provided routinely by clinicians.
Information provided to patients needs to better address the questions that patient's ask and also questions that the patients' should ask! There must be more effort to explain the medical jargon, and a more adequate coverage of issues pertinent to patient decision making particularly when speed is of the essence. The information needs to be updated for currency on a regular basis.
Clinical online tools for adjuvant therapy for cancer are readily available. The development of an online tool to assist patients' with initial surgical decisions for breast cancer could also be considered. For those considering mastectomy further information concerning breast reconstruction should be made available prior to initial surgery.