Decision Matrix_Prostate Cancer

	A	B	C	D	E	F	G	H	I	K	L
1	Weighted Decision Matrix - Which Treatment Option is Best for AB?
2	AB's Best Treatment is: Laparascopic/Robotic Prostatectomy										Date last saved: Mar-4-2019
3	Decision Factors		Watchful Waiting (Gleason = 7)	Radiation (Overall)	Surgery (Overall)	Retropubic Prostatectomy (Gold Standard)	Perineal Prostatectomy	Laparoscopic/Robotic Prostatectomy	Androgen Deprivation Treatment (ADT) + Radiation or Surgery (adds 3-10% survival and reduces progression)	Which treament is best for you? The pros and cons of prostate cancer treatment are mutli-factorial. The best treatment depends on a cobination of objective medical outcomes, and how you value particular factors. The scale for this decision matrix is +5 = best outcome to -5 worst outcome. In other words, it is a 10-point scale adapted to show negatives. If you are not sure how to rate a factor, place the value on a 1 to 10 scale, and then adapt it to a -5 to +5. For example, a score of 1 = -5; 2= -4; 3= -3; etc... The ratings in the first four (4) criteria are derived from the scientific literature. Do NOT change these. The ratings for the last three (3) criteria are personal. Adjust these as needed.
4	Criteria	Wt.								Criteria	Definition
5	20-year survival rate from PC	5.000	0.332	0.470	0.770	0.770	0.770	0.770	0.835	20-year survival rate with this option	Likelihood of being alive 25 years after treatment (i.e., not dying from this cancer)
6	15-year survival rate rate from PC	5.000	0.650	0.828	0.890	0.890	0.890	0.890	0.955	15-year survival rate with this option	Likelihood of being alive 20 years after treatment (i.e., not dying from this cancer)
7	10-year survival rate from PC	10.00	0.93	0.99	0.96	0.99	0.99	0.99	1.00	10-year survival rate with this option	Likelihood of being alive 10 years after treatment (i.e., not dying of this cancer)
8	5-year survival rate from PC	15.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	5-year survival rate with this option	Likelihood of being alive 5 years after treatment (i.e., not dying from this cancer)
9	5- year progression-free survival	15.00	0.00	0.87	0.90	0.90	0.90	0.90	0.895-0.93	Risk of recurrence/spread of the tumor with option	Likelihood of tumor returning or spreading
10	Quality of life years (QALY) gained	15.00	0.01	0.72	0.86	0.86	0.86	0.87	0.75-0.9	QALY	Quality of life gained for years after diagnosis
11	Treatment curative success rate ( 1 - failure rate)	15.00	0.00	0.87	0.95	0.95	0.95	0.95	0.895-0.984	Treatment success rate	Likehood that the treatment offers a cure of the current tumor
12	Sub-Total Survival	80	29	68	74	74	74	74
13	No new disease/side effects	3.0	-5.0	2.0	3.6	4.0	3.0	4.0		Side effects of option	Likelihood of acquiring undesirable side effects as a result of treatment
14	Low infection rate	3.0	5.0	5.0	2.0	3.0	2.0	4.0		Infection rate of option	Likelihood of acquiring a new infection as a result of treatment
15	Minimal/no pain	1.0	4.0	4.0	1.0	1.0	2.0	2.0		Pain associated with option that exceeds standard oral management	Not being in pain during treatment or after, where pain cannot be controlled by regular dosing of oral pain medicine
16	Additional diagnostic value of option (i.e., staging, genotyping, node sampling, etc...)	3.0	-5.0	2.0	5.0	5.0	5.0	5.0		Additional diagnostic value of option (i.e., staging, genotyping, node sampling, etc...)	What else can be learned about this cancer as a result of treatment
17	Future treatment options available after taking this option (e.g., all, one, none)	3.0	-1.0	-5.0	5.0	5.0	5.0	5.0		Future treatment options available after taking this option (e.g., all, one, none)	In the event of a recurrence or spread of this tumor, the number of treatment options that remain available
18	Minimal/no regret: Feeling less masculine	0.0	5.0	2.9	-3.1	-3.1	-3.1	-3.1
19	Loss of libido	1.0	-5.0	-2.0	-1.8	-1.8	-1.8	-1.8
20	Sexual function	1.0	-5.0	-2.0	0.4	0.4	0.4	0.4
21	Urinary function	3.0	4.0	3.0	0.4	0.4	0.4	0.4
22	Cancer worry	1.0	-5.0	-2.0	0.6	0.6	0.6	0.6
23	Needs to void on a toilet and avoid bed pans	2.0	5.0	5.0	4.0	4.0	4.0	5.0		Needs to void on a toilet - Dealbreaker aversion to bed pans	Protect privacy and dignity of bowel movements by using a toile;, no bed pans
24	Travel to Buffalo in April and Switzerland before Dec 2019	3.0	5.0	5.0	5.0	5.0	5.0	5.0		Travel to Buffalo in April and Switzerland before Dec 2019	Able to travel safely without risk of lymph edema and sit comfortably on long-haul drives and flights after post-treatment recovery period
25	Able to sit comfortably on a stool and play music within three months	3.0	5.0	4.0	3.0	3.0	2.0	5.0		Able to sit comfortably on a stool and play music	Able to sit comfortable on a stool as needed to play music gigs after post-treatment recovery period
26	Return to playing music within three months	3.0	5.0	4.0	4.0	4.0	4.0	5.0		Return to playing music within three months or less of treatment	Return to playing music in the same amount of time or less as after knee surgeries
27	Sub-Total Needs and Values	30	38	26	29	31	29	37
28	Total Score		67	94	103	104	102	110		Note on calculationThe formula for weighted scores uses a Sumproduct formula and has conditional formatting applied. Please check that the formula and conditional formatting includes the correct cell ranges if you add or remove any rows or columns.
29	INSTRUCTIONS:
30	Select and insert a score of -5 to +5 for each criteria. The score will be multiplied by the weight to arrive at the total weighted score.
31	Keep the first column for status quo (i.e. do nothing) and score the options against the status quo.
32	KEY TO COLOR CODING:
33	Survial
34	Objective criteria
35	Subjective criteria
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