Grant Number:	1R01CA315840-01 Interpret this number
Primary Investigator:	Salwei, Megan
Organization:	Vanderbilt University Medical Center
Project Title:	Improving Personalized Breast Cancer Care Through a Computerized Patient Adaptable Shared Decision-Making System (COMPASS)
Fiscal Year:	2026

The proposed research addresses an urgent need to deliver personalized breast cancer care. Breast cancer is the most common cancer in women, with approximately 310,000 new cases diagnosed each year. Breast cancer treatment is complex as the treatment approach can vary significantly depending on a patient’s tumor and clinical characteristics and is based on individual patient values and preferences. Patients can struggle to understand this treatment complexity, which hinders their ability to make informed treatment decisions. Approximately 50% of breast cancer patients do not make high-quality treatment decisions and over 70% of patients experience decisional regret. While there are numerous decision aids for breast cancer patients, challenges integrating these tools into clinical workflows has limited widespread use. Previous decision aids have also had limited ability to personalize the information presented to each patient. To address these challenges, we developed a COMputerized Patient Adaptable Shared decision-making System (COMPASS) to support breast cancer patient decision making and personalized treatment journeys. COMPASS is integrated in the electronic health record (EHR) and patient portal and leverages natural language processing (NLP) to provide personalized information to patients about their diagnosis and treatment options. COMPASS also includes clinician-facing and team-based components to support shared decision- making. Breast cancer patients reported high acceptance and usability of COMPASS in a simulated setting and 100% of patients said they wished they had COMPASS when they were diagnosed with breast cancer. We propose to conduct a Hybrid Type I Effectiveness-Implementation Study to evaluate the real-world efficacy of COMPASS. We will conduct a randomized controlled trial (RCT), enrolling 300 newly diagnosed breast cancer patients at one academic medical center over 2 years. Our specific aims are: Aim 1. To evaluate the effect of COMPASS on patient-centered breast cancer decision-making. Hypothesis: Compared to usual care, patients using COMPASS will have lower decision regret measured with the validated Decision Regret Scale (DRS). We will also measure patient-reported decision quality, decision confidence, patient-centered communication, and shared decision-making. Aim 2. To evaluate the effect of COMPASS on patients’ anxiety, symptom burden, and quality of life. Hypothesis: COMPASS will reduce anxiety and symptom burden and improve quality of life. Aim 3. To identify barriers and facilitators to deploying COMPASS in a future multi-site RCT. Guided by the Consolidated Framework for Implementation Research (CFIR), we will conduct interviews and observations with key stakeholders at three breast clinics nationwide to prepare for future implementation of COMPASS. We propose that COMPASS will improve patient-centered and personalized breast cancer decision making, the quality of care, and patient outcomes.





None