Method of presenting oncology treatment outcomes influences patient treatment decision-making in metastatic colorectal cancer.

BACKGROUND: The methods used to communicate relevant outcomes in oncology to patients will likely influence treatment decisions. The purpose of this study was to examine the influence of three different methods of describing the efficacy of therapy on treatment decisions regarding management of metastatic colorectal cancer. METHODS: Participants reviewed a clinical scenario and randomly received one of three ways of describing efficacy of chemotherapy in metastatic colorectal cancer: (1) relative risk reduction, (2) tumor response rate, and (3) median overall survival. They received the same clinical scenario but were presented four treatment options: (1) observation and supportive care, (2) chemotherapy, (3) surgery, and (4) surgery and chemotherapy and the accompanying median overall survival estimate. RESULTS: Participants included 102 preclinical medical students. In the first scenario, 85% chose chemotherapy in the relative risk reduction group, as did 88% of the tumor response rate group, but significantly fewer participants did so in the median overall survival group (35%; P < .001). In the second scenario, there was a significant difference in treatment preferences, with 4% of participants choosing observation/supportive care. None chose chemotherapy only, 19% chose surgery only, and 77% chose surgery plus chemotherapy (P < .001). CONCLUSIONS: This study demonstrated that different methods of describing oncology treatment outcomes associated with therapy for metastatic colorectal cancer to the liver can have a dramatic effect on patient treatment decisions.

Preferences for different methods of communicating information regarding adjuvant chemotherapy for breast cancer.

Many patients play an active role in determining their cancer treatments, and the communication of medical information influences patient decision-making. This study examined participants' preferences between various methods of communicating quantitative risks and benefits of adjuvant chemotherapy. Using clinical vignettes, participants were first asked to decide whether or not to endorse chemotherapy and were subsequently asked about their preferences for the methods used to communicate the risks and benefits. Participants preferred the absolute survival benefit method over negatively framed methods, such as relative or absolute risk reduction. We also present analysis of qualitative data which supports the conclusions drawn from quantitative analyses. In summary, the absolute survival benefit was shown to be the superior method of communicating quantitative risks and benefits of chemotherapy. Failure to use clear and concise methods of communicating quantitative risk and benefit information may compromise efforts to obtain informed consent for treatment.