INTRODUCTION
toxicity, cancer, prostate cancer
CANCER, PROSTATE CANCER
Healthcare costs are rising substantially in the United States and internationally,Although financial toxicity affects patients with cancer worldwide,In the context of early‐stage, favourable risk prostate cancer,We previously developed a conversation‐based decision aid (called an Option Grid [OG]) containing information about low‐risk prostate cancer management options. OGs are brief tabular comparisons of options that activate patients before clinical visits and facilitate efficient conversations during visits.In this study, we aimed to assess the impact of a conversation‐based decision aid (OG) containing cost information about low‐risk prostate cancer management options, combined with a brief training session for urologic surgeons, on the frequency and quality of patient‐urologic surgeon cost conversations. We hypothesised that:1.1: Urologic surgeons assigned to training and use of the decision aid would engage in more frequent cost conversations than urologic surgeons in usual care.1.2: Urologic surgeons assigned to training and use of the decision aid would be more likely to make a referral (e.g., to social service organisations, billing representatives, social workers or financial navigators) to address specific cost details than urologic surgeons in usual care.1.3 (Exploratory): Patients of urologic surgeons assigned to training and use of the decision aid would have lower financial toxicity at 3 months follow‐up than patients of urologic surgeons in usual care.We also aimed to examine the impact of the conversation‐based decision aid and surgeon training on decision quality, including measures of decisional conflict, decision regret, and shared decision‐making. We hypothesised that:2.1: Patients of urologic surgeons assigned to training and use of the decision aid would report less decisional conflict, less decisional regret at 3 months follow‐up, and more shared decision‐making than patients in usual care.