Question

Not all decisions you are faced with require serious thought, but there are some that could have long-term consequences. In which scenario would the DECIDE Process be very useful?

Answer 1

Example scenario: a patient with early-stage breast cancer must choose between breast-conserving surgery plus radiation or mastectomy (with or without reconstruction). The decision has major long-term consequences for survival, recurrence risk, body image, recovery time and future surveillance.

How DECIDE would help (brief mapping):
- D — Determine the problem: identify that a treatment choice must be made now that will affect long‑term outcomes and quality of life.
- E — Establish criteria: list what matters (survival/recurrence risk, complication rates, recovery time, cosmetic outcome, need for future procedures, patient values and social/support factors).
- C — Consider alternatives: lumpectomy + radiation, mastectomy +/- reconstruction, participation in a trial, conservative management if appropriate.
- I — Identify the best alternative: compare evidence and criteria, weigh risks/benefits, include the patient’s preferences and lifestyle.
- D — Develop and implement a plan: schedule the chosen procedure, arrange pre‑op counseling, plan reconstruction/rehab, obtain informed consent.
- E — Evaluate and monitor: follow up on outcomes, manage complications, reassess quality of life and need for further treatment.

Why useful: the DECIDE Process structures complex, high‑stakes choices so clinical evidence, risks, and patient values are considered systematically, reducing overlooked factors and improving shared decision‑making.