Development of the PREDICT-Kidney online tool to promote informed decision-making about kidney cancer follow-up care: a qualitative co-design study

Objective: Co-design of the PREDICT-Kidney online tool by patients, members of the public and healthcare professionals (HCPs), to support the communication of the risk of recurrence following surgical treatment for kidney cancer. Design: Qualitative co-design study. Using an iterative process, feedback was collected (via workshops), prioritised and implemented. Setting: Online workshops with participants from across the United Kingdom were conducted between December 2023 and November 2024. Participants: Eighteen adult participants, including patients surgically treated for kidney cancer, members of the public without a history of kidney cancer and HCPs involved in kidney cancer care. Primary and secondary outcomes: To produce an online tool to support the communication of risk of kidney cancer recurrence that is easy to use, easy to understand and acceptable to stakeholders. Secondary outcomes are the properties of the feedback collected, including volume and type. Results: Across nine workshops, 99 discrete feedback items were collected, resulting in 71 actionable changes to the initial prototype tool. Differences in priorities were observed between participant groups, especially around the inclusion of information about competing risks of death. Participants valued the tool for improving consistency of follow-up information, supporting shared decision-making, and providing multiple visual formats to communicate risk. Iterative feedback led to refinements in terminology, design, content, and delivery, including adjustments to the presentation of recurrence and mortality risk. Conclusions: A co-design approach was used to improve the PREDICT-Kidney online tool to align with the needs of patients and HCPs. A feasibility study is required to evaluate its use and impact in clinical practice.