Decisions for lung cancer chemotherapy: the influence of physician and patient factors

Davidson, Patricia M.; Jiwa, Moyez; Goldsmith, Alice J.; McGrath, Sarah J.; DiGiacomo, Michelle; Phillips, Jane; Agar, Meera; Newton, Phillip J.; Currow, David C.

doi:10.1007/s00520-011-1176-y

Cited by 15 publications

(12 citation statements)

References 37 publications

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“…Davidson et al . (), who reviewed the literature regarding the influence of physician and patient factors when determining lung cancer chemotherapy, also identified a mismatch between the physicians' perceptions and the patients' preferences. This finding should encourage patients to express their preferences.…”

Section: Discussionmentioning

confidence: 99%

Preferences of lung cancer patients for treatment and decision-making: a systematic literature review

et al. 2015

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The consideration of patient preferences in decision-making has become more important, especially for life-threatening diseases such as lung cancer. This paper aims to identify the preferences of lung cancer patients with regard to their treatment and involvement in the decision-making process. We conducted a systematic literature review from 12 electronic databases and included studies published between 2000 and 2012. A total of 20 studies were included in this review. These revealed that lung cancer patients do have preferences that should be considered in treatment decisions; however, these preferences are not homogenous. We found that patients often consider life extension to be more important than the health-related quality of life or undesirable side effects. This preference seems to depend on patient age. Nausea and vomiting are the most important side effects to be avoided; the relevance of other side effects differs highly between subgroups. The majority of lung cancer patients, nevertheless, seem to prefer a passive rather than an active role in decision-making, although the self-reported preferences differed partly from the physicians' perceptions. Overall, we identified an urgent need for larger studies that are suitable for subgroup analyses and incorporate multi-attributive measurement techniques.

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Section: Discussionmentioning

confidence: 99%

Preferences of lung cancer patients for treatment and decision-making: a systematic literature review

et al. 2015

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“…Factors that influence treatment decisions among patients and physicians may differ substantially. Patients may value survival benefits more highly and may accept greater risk associated with less treatment benefit, whereas physicians may put more emphasis on treatment‐related adverse events . For instance, in a review of the literature about patient preferences, Davidson et al noted that lung cancer patients were more likely to accept chemotherapy—and with less potential benefit—than their health care providers.…”

Section: Methodsmentioning

confidence: 99%

“…Patients may value survival benefits more highly and may accept greater risk associated with less treatment benefit, whereas physicians may put more emphasis on treatment‐related adverse events . For instance, in a review of the literature about patient preferences, Davidson et al noted that lung cancer patients were more likely to accept chemotherapy—and with less potential benefit—than their health care providers. However, in another review, Zafar et al explained that patients struggle with balancing survival with quality of life, and these preferences can evolve over the course of treatment; in 1 study, patients who had undergone treatment were willing to trade‐off survival benefit for quality of life in hypothetical scenarios .…”

Section: Methodsmentioning

confidence: 99%

Implementing and evaluating shared decision making in oncology practice

Kane

Halpern

Squiers

et al. 2014

CA A Cancer J Clinicians

239

161

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Engaging individuals with cancer in decision making about their treatments has received increased attention; shared decision making (SDM) has become a hallmark of patient-centered care. Although physicians indicate substantial interest in SDM, implementing SDM in cancer care is often complex; high levels of uncertainty may exist, and health care providers must help patients understand the potential risks versus benefits of different treatment options. However, patients who are more engaged in their health care decision making are more likely to experience confidence in and satisfaction with treatment decisions and increased trust in their providers. To implement SDM in oncology practice, physicians and other health care providers need to understand the components of SDM and the approaches to supporting and facilitating this process as part of cancer care. This review summarizes recent information regarding patient and physician factors that influence SDM for cancer care, outcomes resulting from successful SDM, and strategies for implementing SDM in oncology practice. We present a conceptual model illustrating the components of SDM in cancer care and provide recommendations for facilitating SDM in oncology practice.

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“…18 Effective clinician-to-patient communication about lung cancer has been shown to increase the probability of receiving appropriate cancer-directed therapies, including chemotherapy. 19,20 …”

Section: Discussionmentioning

confidence: 99%

Communication About the Probability of Cancer in Indeterminate Pulmonary Nodules

et al. 2018

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IMPORTANCE Clinical guidelines recommend that clinicians estimate the probability of malignancy for patients with indeterminate pulmonary nodules (IPNs) larger than 8 mm. Adherence to these guidelines is unknown. OBJECTIVES To determine whether clinicians document the probability of malignancy in high-risk IPNs and to compare these quantitative or qualitative predictions with the validated Mayo Clinic Model. DESIGN, SETTING, AND PARTICIPANTS Single-institution, retrospective cohort study of patients from a tertiary care Department of Veterans Affairs hospital from January 1, 2003, through December 31, 2015. Cohort 1 included 291 veterans undergoing surgical resection of known or suspected lung cancer from January 1, 2003, through December 31, 2015. Cohort 2 included a random sample of 239 veterans undergoing inpatient or outpatient pulmonary evaluation of IPNs at the hospital from January 1, 2003, through December 31, 2012. EXPOSURES Clinician documentation of the quantitative or qualitative probability of malignancy. MAIN OUTCOMES AND MEASURES Documentation from pulmonary and/or thoracic surgery clinicians as well as information from multidisciplinary tumor board presentations was reviewed. Any documented quantitative or qualitative predictions of malignancy were extracted and summarized using descriptive statistics. Clinicians’ predictions were compared with risk estimates from the Mayo Clinic Model. RESULTS Of 291 patients in cohort 1, 282 (96.9%) were men; mean (SD) age was 64.6 (9.0) years. Of 239 patients in cohort 2, 233 (97.5%) were men; mean (SD) age was 65.5 (10.8) years. Cancer prevalence was 258 of 291 cases (88.7%) in cohort 1 and 110 of 225 patients with a definitive diagnosis (48.9%) in cohort 2. Only 13 patients (4.5%) in cohort 1 and 3 (1.3%) in cohort 2 had a documented quantitative prediction of malignancy prior to tissue diagnosis. Of the remaining patients, 217 of 278 (78.1%) in cohort 1 and 149 of 236 (63.1%) in cohort 2 had qualitative statements of cancer risk. In cohort 2, 23 of 79 patients (29.1%) without any documented malignancy risk statements had a final diagnosis of cancer. Qualitative risk statements were distributed among 32 broad categories. The most frequently used statements aligned well with Mayo Clinic Model predictions for cohort 1 compared with cohort 2. The median Mayo Clinic Model–predicted probability of cancer was 68.7% (range, 2.4%–100.0%). Qualitative risk statements roughly aligned with Mayo predictions. CONCLUSIONS AND RELEVANCE Clinicians rarely provide quantitative documentation of cancer probability for high-risk IPNs, even among patients drawn from a broad range of cancer probabilities. Qualitative statements of cancer risk in current practice are imprecise and highly variable. A standard scale that correlates with predicted cancer risk for IPNs should be used to communicate with patients and other clinicians.

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Decisions for lung cancer chemotherapy: the influence of physician and patient factors

Cited by 15 publications

References 37 publications

Preferences of lung cancer patients for treatment and decision-making: a systematic literature review

Preferences of lung cancer patients for treatment and decision-making: a systematic literature review

Implementing and evaluating shared decision making in oncology practice

Communication About the Probability of Cancer in Indeterminate Pulmonary Nodules

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