Patients' and clinicians' preferences in adjuvant treatment for high-risk endometrial cancer: Implications for shared decision making

Post, Cathalijne; Mens, Jan Willem M.; Haverkort, Marie A.D.; Koppe, F.; Jürgenliemk-Schulz, Ina M.; Snyers, A.; Roeloffzen, Ellen M.A.; Schaake, Eva E.; Slot, Annerie; Stam, T.; Beukema, Jannet C.; Berg, H. van den; Lutgens, Ludy; Nijman, Hans W.; Kroon, Cornelis D. de; Kroep, Judith R.; Stiggelbout, Anne M.; Creutzberg, Carien L.

doi:10.1016/j.ygyno.2021.03.004

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…The probability that a given treatment will successfully eliminate the tumor, the probability of recurrence, the probability of surviving across a given period, the probability of treatment side effects or debilitating outcomes-these numbers should help to inform decisions among different treatment options. The task of comprehending and comparing these varied statistics is daunting, particularly under stress, and certainly there is evidence that better comprehension of these numbers does influence cancer decisions [55][56][57][58][59][60][61][62][63][64][65] and that decision aids that improve numeric comprehension do support decision processes. [66][67][68] Nevertheless, improving numeric comprehension has limited benefit because comprehension is not the only decision-making hurdle.…”

Section: Discussionmentioning

confidence: 99%

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Lacey

Dayal

et al. 2023

Med Decis Making

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Background Past studies have shown a commission bias for cancer treatment, a tendency to choose active treatment even when watchful waiting is less risky. This bias suggests motivations for action beyond mortality statistics, but recent evidence suggests that individuals differ in their emotional sensitivity to probabilities (ESP), the tendency to calibrate emotional reactions to probability. The current study aims to examine the role of ESP in the commission bias, specifically whether those higher in ESP are more likely to choose watchful waiting when risk probabilities align with that choice. Methods Participants ( N = 1,055) read a scenario describing a hypothetical cancer diagnosis and chose between surgery and watchful waiting, with random assignment between versions where the mortality rate was either lower for surgery or for watchful waiting. We modeled choice using the Possibility Probability Questionnaire (PPQ), a measure of ESP, and several other individual differences in a logistic regression. Results We observed a commission bias as in past studies with most participants choosing surgery both when surgery was optimal (71%) and when watchful waiting was optimal (58%). An ESP × Condition interaction indicated that the predictive role of ESP depended on condition. Those higher in ESP were more likely to choose surgery when probabilities favored surgery, β = 0.57, P < 0.001, but when probabilities favored watchful waiting, ESP had a near-zero relationship with choice, β = 0.05, P < 0.99. Conclusions The role of ESP in decision making is context specific. Higher levels of ESP predict choosing action when that action is warranted but do not predict a shift away from surgery when watchful waiting offers better chances of survival. ESP does not overcome the commission bias. Highlights Past studies have identified a “commission bias,” a tendency to choose active treatment over watchful waiting, even when mortality rate is lower for waiting. Evaluation of risk probabilities is related to individual differences in emotional sensitivity to probabilities (ESP) and has been shown to predict reactions to and decisions about health risk situations. ESP appears to be selectively factored into decision making. ESP was a robust predictor of choosing surgery when probability information supported surgery but did not predict decisions when probability information supported watchful waiting. Those who are most emotionally attuned to probabilities are just as susceptible to the commission bias as those who are less attuned.

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Section: Discussionmentioning

confidence: 99%

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Lacey

Dayal

et al. 2023

Med Decis Making

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Differences between physician and patient preferences for cancer treatments: a systematic review

Zhang,

He,

et al. 2023

BMC Cancer

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Background Shared decision-making is useful to facilitate cancer treatment decisions. However, it is difficult to make treatment decisions when physician and patient preferences are different. This review aimed to summarize and compare the preferences for cancer treatments between physicians and patients. Methods A systematic literature search was conducted on PubMed, Embase, PsycINFO, CINAHL and Scopus. Studies elicited and compared preferences for cancer treatments between physicians and patients were included. Information about the study design and preference measuring attributes or questions were extracted. The available relative rank of every attribute in discrete choice experiment (DCE) studies and answers to preference measuring questions in non-DCE studies were summarized followed by a narrative synthesis to reflect the preference differences. Results Of 12,959 studies identified, 8290 were included in the title and abstract screening and 48 were included in the full text screening. Included 37 studies measured the preferences from six treatment-related aspects: health benefit, adverse effects, treatment process, cost, impact on quality of life, and provider qualification. The trade-off between health benefit and adverse effects was the main focus of the included studies. DCE studies showed patients gave a higher rank on health benefit and treatment process, while physicians gave a higher rank on adverse effects. Non-DCE studies suggested that patients were willing to take a higher risk of adverse effects or lower health benefit than physicians when accepting a treatment. Conclusions Physicians and patients had important preference differences for cancer treatment. More sufficient communication is needed in cancer treatment decision-making.

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Age-Related Differences in Patient Preferences for Adjuvant Chemotherapy for High-Risk Endometrial Cancer

Wakkerman,

Post,

Mens

et al. 2024

Preprint

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Patients' and clinicians' preferences in adjuvant treatment for high-risk endometrial cancer: Implications for shared decision making

Cited by 3 publications

References 23 publications

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Differences between physician and patient preferences for cancer treatments: a systematic review

Age-Related Differences in Patient Preferences for Adjuvant Chemotherapy for High-Risk Endometrial Cancer

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