Physician Recommendations Trump Patient Preferences in Prostate Cancer Treatment Decisions
Karen A. Scherr,Angela Fagerlin,Timothy P. Hofer,Laura D. Scherer,Margaret Holmes-Rovner,Lillie D. Williamson,Valerie C. Kahn,Jeffrey S. Montgomery,Kirsten L. Greene,Biqi Zhang,Peter A. Ubel +10 more
TLDR
Patients’ treatment decisions were based largely on urologists’ recommendations, which, in turn, were based on medical factors and not on patients’ personal views of the relative pros and cons of treatment alternatives.Abstract:
Objective. To assess the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. Methods. We enrolled 257 men with clinically localized prostate cancer (prostate-specific antigen <20; Gleason score 6 or 7) seen by urologists (primarily residents and fellows) in 4 Veterans Affairs medical centers. We measured patients’ baseline preferences prior to their urology appointments, including initial treatment preference, cancer-related anxiety, and interest in sex. In longitudinal follow-up, we determined which treatment patients received. We used hierarchical logistic regression to determine the factors that predicted treatment received (active treatment v. active surveillance) and urologist recommendations. We also conducted a directed content analysis of recorded clinical encounters to determine if urologists discussed patients’ interest in sex. Results. Patients’ initial treatment preferences did not predict receipt of active treatment v...read more
Citations
More filters
Journal ArticleDOI
Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy.
TL;DR: Reflecting on whether the current state of medical decision making effectively promotes patients' health care goals concludes that current medical practice often falls short of empowering patients.
Journal ArticleDOI
Factors Influencing Men's Choice of and Adherence to Active Surveillance for Low-risk Prostate Cancer: A Mixed-method Systematic Review.
Netty Kinsella,Netty Kinsella,Pär Stattin,Declan Cahill,Christian Brown,Anna Bill-Axelson,Ola Bratt,Sigrid Carlsson,Sigrid Carlsson,Mieke Van Hemelrijck,Mieke Van Hemelrijck +10 more
TL;DR: The findings suggest that the use of AS could be increased by addressing a variety of factors such as information, psychosocial support, clinician education, and standardised guidelines.
Journal ArticleDOI
Cognitive Bias: The Downside of Shared Decision Making
TL;DR: An overview of common cognitive biases that result from how and when information is presented to patients is presented, providing compelling evidence that patient treatment choices are subconsciously influenced by both known and unknown biases.
Journal ArticleDOI
Decision Support with the Personal Patient Profile-Prostate: A Multicenter Randomized Trial
Donna L. Berry,Fangxin Hong,Traci M. Blonquist,Barbara Halpenny,Christopher P. Filson,Viraj A. Master,Martin G. Sanda,Peter Chang,Gary W. Chien,Randy A. Jones,Tracey L. Krupski,Seth Wolpin,Leslie Wilson,Julia H. Hayes,Quoc-Dien Trinh,Mitchell H. Sokoloff,Prabhakara Somayaji +16 more
TL;DR: In this multicenter trial the decision aid significantly reduced decisional conflict and P3P is an effective adjunct for shared decision making in men with localized prostate cancer.
Journal ArticleDOI
Patients’ Preferences for the Treatment of Metastatic Castrate-resistant Prostate Cancer: A Discrete Choice Experiment
TL;DR: Men with mCRPC showed a strong preference for treatment associated with better control of bone pain, and placed value on treatments that could delay the need for chemotherapy, and they preferred to avoid side effects such as cognition and memory loss, and extreme tiredness.
References
More filters
Journal ArticleDOI
Three Approaches to Qualitative Content Analysis
Hsiu-Fang Hsieh,Sarah E. Shannon +1 more
TL;DR: The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
Journal ArticleDOI
Shared Decision Making — The Pinnacle of Patient-Centered Care
TL;DR: The most important attribute of patient-centered care is the active engagement of patients when fateful health care decisions must be made when they arrive at a crossroads of medical options, where diverging paths have different and important consequences.
Journal ArticleDOI
A Note on Robust Variance Estimation for Cluster‐Correlated Data
TL;DR: This brief note presents a general proof that the estimator is unbiased for cluster-correlated data regardless of the setting.
Journal ArticleDOI
Radical prostatectomy versus observation for localized prostate cancer.
Timothy J Wilt,Michael K. Brawer,Karen M. Jones,Michael J. Barry,William J. Aronson,Steven Fox,Jeffrey R. Gingrich,John T. Wei,Patricia Gilhooly,B. Mayer Grob,Imad Nsouli,Padmini Iyer,Ruben Cartagena,Glenn Snider,Claus G. Roehrborn,Roohollah Sharifi,William Blank,Parikshit Pandya,Gerald L. Andriole,Daniel J. Culkin,Thomas M. Wheeler +20 more
TL;DR: Among men with localized prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up.
Journal ArticleDOI
Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update
Ian M. Thompson,James Brantley Thrasher,Gunnar Aus,Arthur L. Burnett,Edith D. Canby-Hagino,Michael S. Cookson,Anthony V. D'Amico,Roger Dmochowski,David T. Eton,Jeffrey D. Forman,S. Larry Goldenberg,Javier Hernandez,Celestia S. Higano,Stephen R. Kraus,Judd W. Moul,Catherine M. Tangen +15 more
TL;DR: The Prostate Cancer Clinical Guideline Update Panel is a free resource for clinicians and researchers to assess the need for and ability to evaluate the risks and benefits of utilizing the PSA in men and women diagnosed with prostate cancer.
Related Papers (5)
10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer
Freddie C. Hamdy,Jenny L Donovan,J. Athene Lane,Malcolm David Mason,Chris Metcalfe,Peter Holding,Michael Davis,Tim J Peters,Emma L Turner,Richard M. Martin,Jon Oxley,M.C. Robinson,John Staffurth,Eleanor I Walsh,Prasad Bollina,James W.F. Catto,Andrew Doble,Alan Doherty,David Gillatt,Roger Kockelbergh,Howard Kynaston,Alan Paul,Philip Powell,Stephen Prescott,Derek J. Rosario,Edward Rowe,David E. Neal,David E. Neal +27 more
Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer
Jenny L Donovan,Freddie C. Hamdy,J A Lane,Malcolm David Mason,Chris Metcalfe,Eleanor I Walsh,Jane M Blazeby,Tim J Peters,Peter Holding,Bonnington S,T Lennon,Lynne Bradshaw,Cooper D,Phillipa Herbert,Howson J,Arwyn Tomos Jones,Norma Lyons,Salter E,Pauline Thompson,Sarah Tidball,Jan Blaikie,Catherine Gray,Prasad Bollina,James W.F. Catto,Andrew Doble,Alan Doherty,David Gillatt,Roger Kockelbergh,Howard Kynaston,Alan Paul,Philip Powell,Stephen Prescott,Derek J. Rosario,Edward Rowe,Michael Davis,Emma L Turner,Richard M. Martin,David E. Neal,David E. Neal +38 more