Sharing patient-reported goals via an app is associated with more fundamental goal communication in neurosurgical consultations for patients with a brain tumor.
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- Record sourced from PubMed, PMID 42061291.
- Also identified by DOI 10.1016/j.pec.2026.109653.
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Abstract
A recent model of shared decision-making (SDM) emphasizes the importance of discussing patients' goals. In this study, we evaluated the effect of brain tumor patients sharing their fundamental goals via an app on goal communication and SDM in neurosurgical consultations. Participants were adults with a presumed brain tumor diagnosis (glioma or meningioma). Data were first collected in an observational group and subsequently in an intervention group using the Goings-On app, in which they documented their fundamental goals (with personal photos) and symptoms. This information was available in a dashboard to the neurosurgeon for use during the consultation. Consultations were audio-recorded. Fundamental patient goals mentioned in the consultation were counted, and the OPTION<sup>MCC</sup> was used to rate verbal SDM behaviors (scale 0-100). Group differences were assessed using General Linear Mixed Models. The average number of goals mentioned was significantly higher in the intervention group (n = 49; 2.8 ±SD1.8) compared to the observational group (n = 66; 0.6 ±SD0.9; p<sub>adj</sub>= 0.002). The mean OPTION<sup>MCC</sup> score did not differ significantly between the observational and intervention group (43.2 versus 50.1; p<sub>adj</sub>= 0.553). The intervention group showed significantly more communication of fundamental goals during neurosurgical consultations, although this did not translate into significantly higher OPTION<sup>MCC</sup> scores. Findings may be explained by a lack of equipoise, limited evidence on goal-related outcomes and limitations of the OPTION<sup>MCC</sup> in capturing goal-based SDM. Future research should explore the evidence and skills neurosurgeons need to respond to patient goals and optimize care aligned with what matters to individual patients. The intervention facilitates communication of fundamental goals between brain tumor patients and neurosurgeons and may also support goal communication for other patient populations facing complex treatment decisions.
Medical subject headings
- Brain Neoplasms
- Goals
- Communication
- Decision Making, Shared
- Physician-Patient Relations
- Mobile Applications
- Patient Participation