Is there evidence for a better health care for cancer patients after a second opinion? A systematic review

Ruetters, Dana; Keinki, Christian; Schroth, Sarah; Liebl, Patrick; Huebner, Jutta

doi:10.1007/s00432-015-2099-7

Cited by 53 publications

(61 citation statements)

References 21 publications

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“…Furthermore, as Ruetters et al [6] mentioned before, the concern about too much information or the delay or time pressure of the therapy start stopped the participants from seeking an SO.…”

Section: Discussionmentioning

confidence: 99%

“…He suggested that emotional factors are the reason for not seeking an SO. A review by Ruetters et al [6] highlighted additional potential reasons: The uncertainty over the purpose of an SO, the confidence and faith in their primary treating physician, the desire not to delay the start of therapy, concerns about too much information, and the fear over an extended period of uncertainty. In a recent review by Hillen et al [2] these same reasons were also mentioned.…”

Section: Introductionmentioning

confidence: 99%

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Why Do Cancer Patients Have Difficulties Evaluating the Need for a Second Opinion and What Is Needed to Lower the Barrier? A Qualitative Study

Peier-Ruser

Greyerz

2018

Oncol Res Treat

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Background: Requesting a second opinion (SO) is common in oncology. The reasons and barriers for patients not seeking an SO have yet been to be investigated. Why do patients have difficulties evaluating their need for an SO and what could be done to minimize these barriers? Patients and Methods: A 2-stage qualitative study was conducted. 1) Participants were studied in 3 focus groups (FGs). The participants themselves analyzed and then grouped their statements into defined categories. 2) Results of the FGs were discussed with 7 experts from different professional backgrounds. The interviews were unstructured and detailed in the protocol. The statements underwent thematic analysis. Results: The following 4 main barriers were identified: 1) state of shock, 2) pressure of time, 3) sense of excessive demands and uncertainty triggered by information overload, 4) fear of jeopardizing the patient-physician relationship. The following 4 main suggestions for minimizing the barriers were identified: 1) written patient information, 2) improvement of communication, 3) patient empowerment (PE), 4) holistic approach. Conclusion: These barriers incapacitate the patients from evaluating the need for an SO. To minimize the barriers, PE, self-management support and shared decision making is recommended. While the implementation of these concepts advances, patients can be empowered by psycho-oncological assistance.

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“…Furthermore, as Ruetters et al [6] mentioned before, the concern about too much information or the delay or time pressure of the therapy start stopped the participants from seeking an SO.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Why Do Cancer Patients Have Difficulties Evaluating the Need for a Second Opinion and What Is Needed to Lower the Barrier? A Qualitative Study

Peier-Ruser

Greyerz

2018

Oncol Res Treat

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“…The most common reasons for obtaining second opinions included dissatisfaction with their initial physician, a desire for more information prior to making a treatment decision, and seeking confirmatory advice about their diagnosis and treatment recommendation. 5 Prior studies show that second opinions may be linked with patient experience with cancer care; patients report higher level of satisfaction with physician communication during the second opinion visit, however, there is no association with perceived quality of care. 3,6,7 …”

Section: Introductionmentioning

confidence: 98%

“…Many of the published studies focused on women with breast cancer, had small sample sizes, frequently lacked racial, ethnic and socioeconomic diversity, and often, represented only single institutions. 5 In the reviewed studies, 6.5% to 36% of cancer patients obtained a second opinion. The most common reasons for obtaining second opinions included dissatisfaction with their initial physician, a desire for more information prior to making a treatment decision, and seeking confirmatory advice about their diagnosis and treatment recommendation.…”

Section: Introductionmentioning

confidence: 99%

Second opinions from urologists for prostate cancer: Who gets them, why, and their link to treatment

Radhakrishnan

Grande

Mitra

et al. 2016

Cancer

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Background Cancer patients are encouraged to obtain second opinions prior to starting treatment. Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. Methods We surveyed men diagnosed with localized prostate cancer in the greater Philadelphia area in 2012-2014. Men were asked if they obtained a second opinion from a urologist, and the reasons why. We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of prostate cancer care. Results 2386 men responded to the survey (adjusted response rate 51.1%). 40% of men obtained second opinions, commonly because they wanted more information about their cancer (50.8%), and wanted to be seen by the best doctor (46.3%). Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (OR 0.49; 95% CI 0.32-0.73) and men who wanted more information about treatment were less likely to report excellent quality of cancer care (OR 0.70; 95% CI 0.49-0.99) compared to men who did not receive a second opinion. Conclusions While a large proportion of men with localized prostate cancer obtained second opinions, they were not associated with treatment choice or perceived quality of cancer care. Future work is needed to determine when second opinions contribute to increasing the value of cancer care.

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“…Most patients with cancer seeking a second opinion at crucial junctures in care report that the process is helpful and reassuring, regardless of whether such consultations yield a divergent diagnosis or alternative therapies. 7,8 Within established parameters of best practice, nuanced recommendations are expected and encouraged in the pursuit of personalized, patient-centered care, and informed decision making is supported by the clinician community. As an example, the American Cancer Society provides detailed patient resources on this topic and encourages patients to solicit a variety of perspectives to inform their decision making.…”

Section: Physician Practice Variation As a Force In Decision Makingmentioning

confidence: 99%

Should Physicians New to a Case Counsel Patients and Their Families to Change Course at the End of Life?

Honiden

Possick

2018

AMA Journal of Ethics

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Is there evidence for a better health care for cancer patients after a second opinion? A systematic review

Cited by 53 publications

References 21 publications

Why Do Cancer Patients Have Difficulties Evaluating the Need for a Second Opinion and What Is Needed to Lower the Barrier? A Qualitative Study

Why Do Cancer Patients Have Difficulties Evaluating the Need for a Second Opinion and What Is Needed to Lower the Barrier? A Qualitative Study

Second opinions from urologists for prostate cancer: Who gets them, why, and their link to treatment

Should Physicians New to a Case Counsel Patients and Their Families to Change Course at the End of Life?

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