Perspectives of patients with endometrial cancer on use of a personalized risk model for lymph node metastases in counselling

OBJECTIVES: A Bayesian network, ENDORISK, estimates a personalized risk of lymph node metastases (LNM) in patients with endometrial cancer (EC). A qualitative study was conducted to assess the perspectives of patients with EC on the use of ENDORISK in preoperative counselling. METHODS: Content analysis of transcribed semi-structured interviews with 19 patients treated for EC, purposively sampled between 2020 and 2023 from two regional oncology networks in the Netherlands RESULTS: Patients appreciated the potential use of ENDORISK in preoperative counselling to provide information on factors influencing their disease, risk of LNM, and treatment. Use of the model could increase their involvement in decision making on treatment. Emphasizing on the personalized nature of the risk estimation and the potential role of ENDORISK in the decision-making process on treatment could improve explanation of the model. CONCLUSIONS: Using ENDORISK in preoperative counselling could potentially increase patient involvement in shared decision making for EC care. A simple explanation of this model is needed and the professional opinion of clinicians remains important in the treatment process. PRACTICE IMPLICATIONS: In the development and implementation of clinical risk models it is important to include the perspective of the envisioned patient population to ensure clinical relevancy and explainability. This study provides an explorative groundwork for further investigations in the development and implementation of personalized risk estimation models such as ENDORISK.