Determinants of Patient-Oncologist Prognostic Discordance in Advanced Cancer Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Saturday, July 16, 2016

Determinants of Patient-Oncologist Prognostic Discordance in Advanced Cancer



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 Results  Among the 236 patients (mean [SD] age, 64.5 [11.4] years; 54% female), 161 patient-oncologist survival prognosis ratings (68%; 95% CI, 62%-75%) were discordant.


Importance  Patients with advanced cancer often report expectations for survival that differ from their oncologists’ expectations. Whether patients know that their survival expectations differ from those of their oncologists remains unknown. This distinction is important because knowingly expressing differences of opinion is important for shared decision making, whereas patients not knowing that their understanding differs from that of their treating physician is a potential marker of inadequate communication.
Objective  To describe the prevalence, distribution, and proportion of prognostic discordance that is due to patients’ knowingly vs unknowingly expressing an opinion that differs from that of their oncologist.....


Key Points
  • Question When patients with advanced cancer report beliefs about their survival prognosis that differ from the expectations of their oncologists, how often do they know that their beliefs differ?
  • Findings In this cross-sectional analysis of 236 patients and 38 oncologists, 68% of patients held opinions about their survival prognosis that differed from their oncologist and only 1 in 10 discordant patients knew that their opinions differed.
  • Meaning In this study, patient-oncologist discordance about survival prognosis was common and usually due to patients’ inaccurate understanding of their oncologists’ expectations.




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