Digital Health Tools for Complex Treatment Decision-Making in Geriatric Oncology

Aligning treatment decisions with patient values remains a critical yet underexplored challenge in geriatric oncology. We introduced a novel approach to evaluating values-clarification and shared decision-making through simulated patient-clinician encounters. By comparing the digital Values and Outcomes to Improve Cancer Experiences (VOICE) tool with a general communication guide from the American Cancer Society, this pilot randomized trial revealed how tailored decision support tools and clinician engagement can significantly improve the quality of values-based discussions. The findings provide preliminary evidence that situational awareness frameworks can support targeted interventions that both prepare patients to articulate what matters most and encourage clinicians to meaningfully engage with patients to integrate their values into treatment recommendation and decision-making processes.