On the Elicitation of Preferences for Alternative Therapies

McNeil, Barbara J.; Pauker, Stephen G.; Sox, Harold C.; Tversky, Amos

doi:10.1056/nejm198205273062103

Cited by 1,420 publications

(703 citation statements)

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“…As a consequence of the process of reconciliation with the treatment decision the preferences presented here may be too positive in the patients undergoing chemotherapy and too negative in the patients not scheduled for chemotherapy. Studies into treatment preferences have been carried out in patients who have already undergone the particular treatment (Nieuwkerk et al, 1998;Ravdin et al, 1998;Silvestri et al, 1998), in mixed patient groups with some patients having experience and others not (O'Connor, 1989;Kiebert et al, 1993;Yellen et al, 1994;McQuellon et al, 1995;Yellen and Cella, 1995;Cullen et al, 1996;Elit et al, 1996;Brundage et al, 1997;Lindley et al, 1998), in patients who were about to undergo the specific treatment (Slevin et al, 1990;Palda et al, 1997), or in respondents who did not receive the treatment under concern (McNeil et al, 1982;Llewellyn-Thomas et al, 1996). As a result, all studies mentioned above have been carried out in a hypothetical situation and may have been influenced by the effect of 'reconciliation with the treatment decision'.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

et al. 2001

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SummaryWhen making decisions about adjuvant chemotherapy for early-stage breast cancer, costs and benefits of treatment should be carefully weighed. In this process, patients' preferences are of major importance. The objectives of the present study were: (1) to determine the minimum benefits that patients need to find chemotherapy acceptable, and (2) to explore potential preference determinants, namely: positive experience of the treatment, reconciliation with the treatment decision, and demographic variables. Preferences were elicited from patients scheduled for adjuvant chemotherapy (chemotherapy group: n = 38) before (T 1 ), during (T 2 ), and 1 month after chemotherapy (T 3 ), and were compared to responses from patients not scheduled for chemotherapy (no-chemotherapy group: n = 38). The patients were asked, for a hypothetical situation, to indicate the minimum benefit (in terms of improved 5-year disease-free survival) to find adjuvant chemotherapy acceptable. In the chemotherapy group, the median benefit was 1% at all 3 measurement points. In the no-chemotherapy group the attitude towards chemotherapy became more negative over time, although not statistically significantly so (T 1 : 12%, T 2 : 15%, T 3 : 15%; P = 0.10). At all measurement points, the patients in the chemotherapy group indicated that they would accept chemotherapy for significantly (P < 0.01) less benefit than the patients in the no-chemotherapy group. Of the demographic variables, age was related to preferences, but only at T 2 and only in the no-chemotherapy group. The more positive attitude towards chemotherapy and the stability of preferences in the chemotherapy group indicated that reconciliation with the treatment decision was a more important determinant of patients' preferences than positive experience of the treatment.

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Section: Limitations and Future Directionsmentioning

confidence: 99%

Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

et al. 2001

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“…13 More recent evidence indicates that loss-framed messages appear to be successful in promoting behaviours related to early detection, such as clinical skin examinations, 14 mammography screening, 15 breast self examination, 13 and HIV testing. 16 In contrast, gain-framed messages have been found to influence prevention related behaviours such as sunscreen use, 17 preference for surgical procedures, [18][19][20][21] and engaging in regular physical exercise. 22 Because quitting smoking is a preventive health behaviour, these studies suggest that messages designed to encourage smokers to quit might be more effective if they were framed in terms of gains rather than losses.…”

Section: Utilise Gain-framed Messagesmentioning

confidence: 99%

Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective

Strahan

White²,

Fong³

et al. 2002

Tob Control

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Objective: To outline social psychological principles that could influence the psychosocial and behavioural effects of tobacco warning labels, and to inform the development of more effective tobacco warning labels. Data sources: PsycInfo and Medline literature searches and expert guided selection of principles and theories in social psychology and of tobacco warning labels, including articles, books, and reports. Conclusions: Tobacco warning labels represent a potentially effective method of influencing attitudes and behaviours. This review describes social psychological principles that could be used to guide the creation of more effective warning labels. The potential value of incorporating warning labels into a broader public health education campaign is discussed, and directions for future research are suggested.

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“…In contrast to the lack of studies on treatment choice, several studies have been performed on the nature and background of treatment preference (Cassileth et al, 1980;McNeil et al, 1982;Llewellyn-Thomas et al, 1995;Flood et al, 1996;Brundage et al, 1997;Mazur and Hickam, 1997;Lindley et al, 1998;Silvestri et al, 1998;Stalmeier and Bezembinder, 1999;Stiggelbout and de Haes, 2001). In the literature, the patient's preference for treatment is seen and used as an indication for their actual treatment choice.…”

mentioning

confidence: 99%

“…Preferences for treatment are thus usually assessed after patients have received information concerning their treatment options (McNeil et al, 1982;Flood et al, 1996;O'Connor, 1998;Lindley et al, 1998;Silvestri et al, 1998). However, the patient, being a modern consumer of health care, is not a tabula rasa.…”

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confidence: 99%

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

et al. 2003

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In palliative cancer treatment, the choice between palliative chemotherapy and best supportive care may be difficult. In the decisionmaking process, giving information as well as patients' values and preferences become important issues. Patients, however, may have a treatment preference before they even meet their medical oncologist. An insight into the patient's decision-making process can support clinicians having to inform their patients. Patients (n ¼ 207) with metastatic cancer, aged 18 years or older, able to speak Dutch, for whom palliative chemotherapy was a treatment option, were eligible for the study. We assessed the following before they consulted their medical oncologist: (1) socio-demographic characteristics, (2) disease-related variables, (3) quality-of-life indices, (4) attitudes and (5) preferences for treatment, information and participation in decision-making. The actual treatment decision, assessed after it had been made, was the main study outcome. Of 207 eligible patients, 140 patients (68%) participated in the study. At baseline, 68% preferred to undergo chemotherapy rather than wait watchfully. Eventually, 78% chose chemotherapy. Treatment preference (odds ratio (OR) ¼ 10.3, confidence interval (CI) 2.8 -38.0) and a deferring style of decision-making (OR ¼ 4.9, CI 1.4 -17.2) best predicted the actual treatment choice. Treatment preference (total explained variance ¼ 38.2%) was predicted, in turn, by patients' striving for length of life (29.5%), less striving for quality of life (6.1%) and experienced control over the cause of disease (2.6%). Patients' actual treatment choice was most strongly predicted by their preconsultation treatment preference. Since treatment preference is positively explained by striving for length of life, and negatively by striving for quality of life, it is questionable whether the purpose of palliative treatment is made clear. This, paradoxically, emphasises the need for further attention to the process of information giving and shared decision-making.

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On the Elicitation of Preferences for Alternative Therapies

Cited by 1,420 publications

References 4 publications

Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

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