Open Access Research article

Development of a personalized decision aid for breast cancer risk reduction and management

Elissa M Ozanne12*, Rebecca Howe3, Zehra Omer4 and Laura J Esserman3

Author Affiliations

1 Department of Surgery, Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA

2 The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 35 Centerra Parkway, Lebanon, NH 03766, USA

3 Department of Surgery, University of California at San Francisco, San Francisco, CA, USA

4 University of Massachusetts, Worcester, USA

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BMC Medical Informatics and Decision Making 2014, 14:4  doi:10.1186/1472-6947-14-4

Published: 14 January 2014



Breast cancer risk reduction has the potential to decrease the incidence of the disease, yet remains underused. We report on the development a web-based tool that provides automated risk assessment and personalized decision support designed for collaborative use between patients and clinicians.


Under Institutional Review Board approval, we evaluated the decision tool through a patient focus group, usability testing, and provider interviews (including breast specialists, primary care physicians, genetic counselors). This included demonstrations and data collection at two scientific conferences (2009 International Shared Decision Making Conference, 2009 San Antonio Breast Cancer Symposium).


Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (Nā€‰=ā€‰34) provided qualitative feedback about format and design; 88% of these participants found the tool useful and 94% found it easy to use. 91% of the providers (Nā€‰=ā€‰23) indicated that they would use the tool in their clinical setting.

Conclusion represents a new approach to breast cancer prevention care and a framework for high quality preventive healthcare. The ability to integrate risk assessment and decision support in real time will allow for informed, value-driven, and patient-centered breast cancer prevention decisions. The tool is being further evaluated in the clinical setting.

Breast cancer; Decision aid; Risk assessment; Risk reduction; Decision making; Primary care