Limitations
cancer, prostate cancer
CANCER, PROSTATE CANCER
The study has a few limitations. First, although the minority representation was adequate, the patient population was well-educated and had a moderately high income. This makes our sample representative of patients who are more likely to seek second opinions or are visiting a comprehensive cancer center, but is less representative of the population at large. Related to this, failing to oversample African American patients was a missed opportunity, especially important given that African American men are disproportionately affected by prostate cancer with higher incidence and mortality rates. Second, our decision aid was designed for a low-health literate patient population; however, due to the ceiling effect in the health literacy variable, we could not examine whether there was a difference in our outcomes between those with low versus adequate health literacy. As such, this question will be the focus of future work, as testing among patients with very low levels of health literacy awaits.