Table 1 A “typical” CHAMPION study dyad (composite case)

Sample case history: Patient was diagnosed in 2009 with regionally metastatic prostate cancer, underwent surgery to remove the prostate and regional lymph nodes at that time. In 2017, the patient developed an elevated PSA and was diagnosed with bone metastases after imaging and began hormonal treatment. Six months later, the patient experiences bone pain and undergoes additional imaging that shows further metastases. He and his decision partner are approached by the research team to seek consent for participation in CHAMPION following a consultation visit to discuss treatment options with the oncologist. Informed consent is obtained from the patient and the decision partner. Baseline data are collected and the patient-decision partner dyad are enrolled and randomized to the DI arm. The CPN reviews the decision theory and the dyad is introduced to the balance sheet activity via the practice “telling others about cancer” decision. The dyad is sent home with the preloaded mp3 player. Ahead of their return visit, the CPN assesses the dyad’s concerns and conducts the single-event decision (starting, changing or stopping treatment). During the decision visit with the oncologist, there is structured time to discuss any concerns that arose during the balance sheet activity. Over the next 9 months, the CPN maintains regular contact and provides graphical summaries of the patient’s HRQL-PSY symptoms, as reported by both the patient and the decision partner.