Physician Preferences and Shared-Decision Making for the Traditional Chinese Medicine Treatment of Lung Cancer: A Discrete-Choice Experiment Study in China

Abstract

Background With progress being made in the treatment of cancer, various clinical and treatment options are being pursued. In China, Traditional Chinese Medicine (TCM) is used widely in the treatment of cancer. Objective To estimate TCM treatment preferences and SDM mode of physicians in China. Methods This study was conducted among physicians (n=185) from nine tertiary hospitals in China by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-physician version (SDM-Q-Doc) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of physicians were performed using mixed logit models. Additionally, subgroup analysis was conducted. Results In total, 185 respondents completed the questionnaire. All attributes were statistically significant except out-of-pocket costs. Physicians showed the strongest preferences for increasing disease control rate, relieving nausea and vomiting, and reducing the risk of side effects. Most of the physicians (78.38%) self-reported a high willingness to use SDM during the decision-making process. The physicians with a higher SDM-Q-Doc score had more preference for improving all three attributes than those with a lower score. Little variation was found in preferences among the physicians with other sociodemographic characteristics. Conclusion In China, physicians considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The physicians in China mainly preferred SDM, and the preference was different according to SDM mode when involving the TCM therapy for patients with lung cancer. The study findings could inform future TCM therapy for lung cancer and promote SDM.

Barriers and Stimulus in Shared Decision Making Among Aesthetic Dermatologists in China: Findings from a Cross-Sectional Study

“…The median SDM sum score was 88.9 after standardizing the raw score (median value was 40) by a linear transformation to convert the score into a scale ranging from 0 to 100, which demonstrates Chinese dermatologists situate a decent level in implementing SDM, and the finding was in line with previous studies. 4,14 A cross-sectional study implemented in Japan showed that the mean SDM score was 76.9 among 129 physicians who worked at university hospital and municipal hospitals. 4 Another Chinese SDM study regarding lung cancer treatment also indicated that the mean SDM score was 85.4 among 185 physicians.…”

“…In this study, data were collected through electronic questionnaire on Umer Doctor APP. The online questionnaire covered four parts: (1) demographic features including age, sex, education, professional qualification, institution type, private or public institutions, and years of practice in medical aesthetics; (2) SDM-Q-Doc, 14 which consists of nine questions, and the response to each items was assessed through a six-point Likert scale with 0=completely disagree, 1=strongly disagree, 2=somewhat disagree, 3=somewhat agree, 4=strongly agree, and 5=completely agree -the total SDM score is the…”

“…12,13 Previous studies indicated that Chinese physicians perceived SDM with high willingness (78.38%) based on the discrete-choice experiment (DCE) survey and the SDM questionnaire physician version (SDM-Q-Doc) survey. 14 However, studies focusing on SDM in the areas of medicine aesthetic or aesthetic surgery are still lacking, especially with the rising medical aesthetic demands in China. Moreover, Koyama et al 4 stated that factors that promote or hinder SDM implementation might be modified by the specific type of hospital where the physicians work.…”

Medical Conditions and Preference of Traditional Chinese Medicine: Results from the China Healthcare Improvement Evaluation Survey

“…A survey in China showed that more than 83% of cancer patients had used TCM since diagnosis, 23 and 53% of patients in other studies also received TCM treatment during the course of cancer treatment as well as during rehabilitation. 24 During the period of recovery from cancer, TCM focuses on symptoms or the prevention and treatment of recurrence and metastases, 25 , 26 combined with various traditional treatment methods to help patients alleviate symptoms and improve their quality of life. 27–29 This was also reflected by the percentage of patients at cancer hospitals in our study who chose TCM as an effective treatment method for rehabilitation.…”

Assessment of patients’ preferences for new anticancer drugs in China: a best–worst discrete choice experiment on three common cancer types

“…Our findings also provide evidence on what kind of information patients with common types of cancer would like to receive when it comes to making decisions about new anticancer drug therapies. Communications between patients and clinicians about therapeutics play a crucial role in cancer care by improving patient consent and reducing uncertainty in SDM 47 48. Meanwhile, decision aids that provide scientific evidence and help patients evaluate their treatment options deserve to be developed and applied in clinical practice.…”