Table 1 Overview of the draft PtDA's per round

The first draft PtDA was built in the format of a PowerPoint-like presentation. It included two surgical treatment options, survival rates, side effects, all pros and cons of the treatments, pictures of surgical results, and value elicitation statements.

The second draft was built as a website. We used the same content and same number of pictures and graphs to present risks. At the end of the PtDA it showed a summary of the patient’s response to the value clarification statements.

The final structure of the PtDA was established in the third draft. It is a website including interactive elements to provide tailored information to individual patients. Patients gain access into the website with a personal login code. The homepage enables them to personalise the PtDA by using a prescription pad they receive from their clinician. The content consists of the treatment options, including neo-adjuvant therapy and breast reconstruction, pros and cons, side effects and value elicitation statements.