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Cancer Patients' Roles In Treatment Decisions: Do Characteristics Of The Decision Influence Roles?

N. Keating, Mary Beth Landrum, N. Arora, J. Malin, P. Ganz, M. van Ryn, J. Weeks
Published 2010 · Medicine

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PURPOSE Patients with more active roles in decisions are more satisfied and may have better health outcomes. Younger and better educated patients have more active roles in decisions, but whether patients' roles in decisions differ by characteristics of the decision itself is unknown. PATIENTS AND METHODS We surveyed a large, population-based cohort of patients with recently diagnosed lung or colorectal cancer about their roles in decisions regarding surgery, radiation therapy, and/or chemotherapy. We used multinomial logistic regression to assess whether characteristics of the decision, including evidence about the treatment's benefit, whether the decision was likely preference-sensitive (palliative therapy for metastatic cancer), and treatment modality, influenced patients' roles in that decision. RESULTS Of 10,939 decisions made by 5,383 patients, 38.9% were patient controlled, 43.6% were shared, and 17.5% were physician controlled. When there was good evidence to support a treatment, shared control was greatest; when evidence was uncertain, patient control was greatest; and when there was no evidence for or evidence against a treatment, physician control was greatest (overall P < .001). Decisions about treatments for metastatic cancers tended to be more physician controlled than other decisions (P < .001). CONCLUSION Patients making decisions about treatments for which no evidence supports benefit and decisions about noncurative treatments reported more physician control, which suggests that patients may not want the responsibility of deciding on treatments that will not cure them. Better strategies for shared decision making may be needed when there is no evidence to support benefit of a treatment or when patients have terminal illnesses that cannot be cured.
This paper references
Multiple Imputation for Interval Estimation from Simple Random Samples with Ignorable Nonresponse
D. Rubin (1986)
Information needs and decisional preferences in women with breast cancer.
L. Degner (1997)
The Control Preferences Scale.
L. Degner (1997)
Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review.
A. Moyer (1997)
Maximum Likelihood Estimation of Misspecified Models
H. White (1982)
Decision making during serious illness: what role do patients really want to play?
L. Degner (1992)
Multiple imputation in a large-scale complex survey: a practical guide
Y. He (2010)
What role do patients wish to play in treatment decision making?
R. Deber (1996)
Statistical Analysis with Missing Data.
M. G. Gibson (1989)
Analyzing Communication in Medical Consultations: Do Behavioral Measures Correspond to Patients' Perceptions?
R. Street (1992)
Multiple Imputation for Nonresponse in Surveys
W. M. Campion (1989)
Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease
S. Kaplan (1989)
Missing data analysis using multiple imputation: getting to the heart of the matter.
Y. He (2010)
What is the impact of shared decision making on treatment and outcomes for older women with breast cancer?
J. Mandelblatt (2006)
A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly.
C. Turvey (1999)
Increasing patient involvement in choosing treatment for early breast cancer
R. Street (1995)
A multivariate technique for multiply imputing missing values using a sequence of regression models
T. E. Raghunathan (2001)
Patient Participation in Deciding Breast Cancer Treatment and Subsequent Quality of Life
R. Street (1997)
A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.
J. Ware (1996)
Patients’ participation in medical care
S. Greenfield (2007)
Patient participation in decision-making.
E. Guadagnoli (1998)
Understanding cancer treatment and outcomes: the Cancer Care Outcomes Research and Surveillance Consortium.
J. Ayanian (2004)
Patient preferences for medical decision making: who really wants to participate?
N. Arora (2000)
Physicians' decision-making style and psychosocial outcomes among cancer survivors.
N. Arora (2009)
Multiple imputation of discrete and continuous data by fully conditional specification
S. Buuren (2007)
Effective physician-patient communication and health outcomes: a review.
M. Stewart (1995)
Breast cancer care in older women
R. Silliman (1998)
Applications of multiple imputation in medical studies: from AIDS to NHANES
J. Barnard (1999)
The case identification challenge in measuring quality of cancer care.
M. Pearson (2002)
Determinants of participation in treatment decision-making by older breast cancer patients
R. Maly (2004)

This paper is referenced by
Patients' participation in decision-making in the medical field--'projectification' of patients in a neoliberal framed healthcare system.
Stinne Glasdam (2015)
Systematic Assessment of Factors Influencing Preferences of Crohn's Disease Patients in Selecting an Anti‐Tumor Necrosis Factor Agent (CHOOSE TNF TRIAL)
S. Vavricka (2012)
Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care: Workshop Summary
M. Patlak (2014)
Patient and physician decision styles and breast cancer chemotherapy use in older women: Cancer and Leukemia Group B protocol 369901.
J. Mandelblatt (2012)
A Literature Review of Patient Education: Is IT Time to Move Forward?
Rochelle McIntyre (2015)
Predictors of newly diagnosed cancer patients' understanding of the goals of their care at initiation of chemotherapy
I. Lennes (2013)
Patients' expectations about effects of chemotherapy for advanced cancer.
J. Weeks (2012)
Early initiation of palliative care is associated with reduced late-life acute-hospital use: A population-based retrospective cohort study
D. Qureshi (2019)
Delivering Patient-Centered Care in the Setting of Advanced Cancer: What Does a Clinical Risk-Prediction Model Have to Do With It?
P. Ganz (2015)
Knowledge, attitudes and decision-making preferences of men considering participation in the TROG RAVES Prostate Cancer Trial (TROG 08.03).
Stephanie Tesson (2016)
Application of decision-analytic models in personalized medicine for CML treatment decisions made by payers, providers, and patients.
K. Saverno (2012)
Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial
Linda J. M. Oostendorp (2017)
Palliative Chemotherapie oder doch besser Palliative Care
Markus Borner (2015)
L’autonomie de décision du patient : du concept à la pratique cancérologique
J. Raoul (2017)
Understanding the Needs of Patients with Metastatic Breast Cancer: Results of the Make Your Dialogue Count Survey
A. Brufsky (2017)
Palliative communications: addressing chemotherapy in patients with advanced cancer.
K. C. Kadakia (2012)
Shared decision‐making and patient control in radiation oncology: Implications for patient satisfaction
J. Shabason (2014)
Topics and Applications in Synthetic Data
B. Loong (2012)
Shared decision-making in pediatric allogeneic blood and marrow transplantation: what if there is no decision to make?
R. Pentz (2012)
Characteristics Associated With Preferences for Parent-Centered Decision Making in Neonatal Intensive Care
E. Weiss (2018)
Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey
V. Zagonel (2016)
Biblioteca Telemática. Entrega 44
Ana de Santiago (2011)
Does good practice quality equate to earlier cancer stage at diagnosis
Helen Wareham (2015)
Cancer Patient and Survivor Research From the Cancer Information Service Research Consortium: A Preview of Three Large Randomized Trials and Initial Lessons Learned
A. Marcus (2013)
African American prostate cancer survivors' treatment decision-making and quality of life.
N. Palmer (2013)
Chemotherapy use and patient treatment preferences in advanced colorectal cancer
S. Zafar (2013)
Factors associated with oncology patients' involvement in shared decision making during chemotherapy
Alexis Colley (2017)
Shared decision making in palliative cancer care: a literature review
C. Feuz (2014)
A multidisciplinary approach in providing transitional care for patients with advanced cancer.
Erica M Tuggey (2014)
About clinical trials Among Patients With Newly Diagnosed lung and colorectal cancer
Arora (2014)
Who makes the decision regarding the treatment of clinically localized prostate cancer–the patient or physician?
L. Song (2013)
A scoring system to guide the decision for a new systemic treatment after at least two lines of palliative chemotherapy for metastatic cancers: a prospective study
B. Chanez (2017)
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