Risk-reducing salpingectomy with delayed oophorectomy in BRCA1/2 mutation carriers: Patients' and professionals' perspectives

Jong, M.A.D.W. de; Harmsen, Marline G.; Hoogerbrugge, Nicoline; Massuger, Leon F.A.G.; Hermens, Rosella; Hullu, Joanne A. de

doi:10.1016/j.ygyno.2014.12.031

Cited by 31 publications

(54 citation statements)

References 31 publications

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“…18 Therefore, RSDO is theoretically feasible for BRCA mutation carriers and clinical trials are ongoing. 19,20 Most respondents (91.5%, 43/47) in the present survey agreed with the choice of RSDO rather than RRSO for BRCA mutation carriers. More than two third of the respondents had willingness to recommended RSDO to candidates after confirming sufficient evidence (Fig.…”

Section: Discussionmentioning

confidence: 66%

Practice Patterns of Hereditary Ovarian Cancer Management in Korea

Choi

Lim²,

Lee

et al. 2017

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 66%

Practice Patterns of Hereditary Ovarian Cancer Management in Korea

Choi

Lim²,

Lee

et al. 2017

International Journal of Gynecological Cancer

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“…In the case of a falsepositive test result, it is often assumed that patients are given an unnecessary surgical procedure, typically an oophorectomy. This is of interest as an oophorectomy can reduce the risk of ovarian cancer by 80% to 90%, 22 and thus reduce the mortality rate of patients. Consequently, this issue has to be handled very carefully in modeling studies in this setting.…”

Section: Discussionmentioning

confidence: 99%

Methods Used in Economic Evaluations of Testing and Diagnosis for Ovarian Cancer: A Systematic Review

Sharma¹,

Sundar

Breheny³

et al. 2016

Int J Gynecol Cancer

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Objective: There are multiple tests available which can help diagnose ovarian cancer, and the cost effective analysis of these diagnostic interventions is essential for making well informed decisions regarding resource allocation. There are multiple factors that can impact on the conclusions drawn from economic evaluations including test accuracy, the impact of the testing pathway on patient costs and outcomes, and delays along the ovarian cancer test-treat pathway. The objective of this study was to evaluate how test accuracy, the choice of perspective, and delays along the testing and diagnostic pathway have been incorporated in economic evaluations of testing for ovarian cancer.Method: A systematic review of published literature was undertaken to identify economic evaluations (e.g. cost-effectiveness, cost-utility analysis) focused on testing and diagnosis for ovarian cancer.Results: Seven studies met the inclusion criteria. Six studies incorporated test accuracy and its impact on patients to some extent. Four studies adopted a societal perspective, but only one considered the costs incurred by patients on the testing and diagnosis pathway. Where delays on the testing pathway were incorporated into the analysis, these were frequently due to false negative test results leading to delays in patients accessing treatment. Any anxiety that patients might experience as a result of a positive test was not considered in these studies. Conclusion:The impact on patients of receiving a positive test in terms of anxiety, and the costs incurred by patients having to attend for testing and diagnosis are rarely considered. Delays along the testing and diagnosis pathway can have a major effect on patient outcomes, and it is important that these are acknowledged in economic evaluations focused on testing. Future economic analysis should incorporate these key determinants in order that diagnostic tests for ovarian cancer can be robustly evaluated.

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“…Points of consideration in the choice between RRSO and salpingectomy with delayed oophorectomy were extracted from the literature, searching the Medline database for “ BRCA ” or equivalents and “salpingectomy” or “delayed oophorectomy.” Furthermore, we interviewed 39 BRCA1/2 mutation carriers and 23 of their health‐care professionals in the process of designing the aforementioned preference trial . The purpose of these interviews was to explore barriers and facilitators for the introduction of salpingectomy with delayed oophorectomy as alternative risk‐reducing strategy.…”

Section: Methodsmentioning

confidence: 99%

“…The second draft was sent to a patient expert panel consisting of six BRCA1/2 mutation carriers who had one or more consultations at our tertiary hospital and had already undergone RRSO. They agreed to get invited for any BRCA‐ related research projects at the time they participated in a previous study . Although they do not belong to the ultimate target population, we invited these women to assess the decision aid for two reasons: first, they know the consequences of salpingo‐oophorectomy from their own experience and second, we considered it unethical to offer a preliminary version of the decision aid to women who still had to make a choice for either strategy.…”

Section: Methodsmentioning

confidence: 99%

A patient decision aid for risk‐reducing surgery in premenopausal BRCA1/2 mutation carriers: Development process and pilot testing

Harmsen

Steenbeek

Hoogerbrugge

et al. 2017

Health Expectations

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Background BRCA1/2 mutation carriers’ choice between risk‐reducing salpingo‐oophorectomy (RRSO) and salpingectomy with delayed oophorectomy is very complex. Aim was to develop a patient decision aid that combines evidence with patient preferences to facilitate decision making.DesignSystematic development of a patient decision aid in an iterative process of prototype development, alpha testing by patients and clinicians and revisions using International Patient Decision Aid Standards (IPDAS) quality criteria. Information was based on the available literature and current guidelines. A multidisciplinary steering group supervised the process.Setting and participantsPre‐menopausal BRCA1/2 mutation carriers choosing between RRSO and salpingectomy with delayed oophorectomy in Family Cancer Clinics in the Netherlands.Main outcome measuresIPDAS quality criteria, relevance, usability, clarity.ResultsThe patient decision aid underwent four rounds of alpha testing and revisions. Finally, two paper decision aids were developed: one for BRCA1 and one for BRCA2. They both contained a general introduction, three chapters and a step‐by‐step plan containing a personal value clarification worksheet. During alpha testing, risk communication and information about premature menopause and hormone therapy were the most revised items. The patient decision aids fulfil 37 of 43 (86%) IPDAS criteria for content and development process.Discussion and conclusionsBoth BRCA1/2 mutation carriers and professionals are willing to use or offer the developed patient decision aids for risk‐reducing surgery. The patient decision aids have been found clear, balanced and comprehensible. Future testing among patients facing the decision should point out its effectiveness in improving decision making.

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Risk-reducing salpingectomy with delayed oophorectomy in BRCA1/2 mutation carriers: Patients' and professionals' perspectives

Cited by 31 publications

References 31 publications

Practice Patterns of Hereditary Ovarian Cancer Management in Korea

Practice Patterns of Hereditary Ovarian Cancer Management in Korea

Methods Used in Economic Evaluations of Testing and Diagnosis for Ovarian Cancer: A Systematic Review

A patient decision aid for risk‐reducing surgery in premenopausal BRCA1/2 mutation carriers: Development process and pilot testing

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