Perceptions of patients and physicians regarding phase I cancer clinical trials: Implications for physician-patient communication
Perceptions of patients and physicians regarding phase I cancer clinical trials: Implications for physician-patient communication
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DOI：
10.1200/jco.2003.10.072
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发表时间：
2003-07-01
影响因子：
45.3
通讯作者：
Schulman, KA
中科院分区：
文献类型：
--
作者：
Meropol, NJ;Weinfurt, KP;Schulman, KA
目的：描述和比较癌症患者及其医生对I期临床试验的看法。方法：符合条件的患者已参加I期试验，并已决定参加，但尚未开始治疗。每位患者的医生也是研究对象。患者和医生完成问卷调查，包括对治疗的潜在益处和危害的看法（实验性和标准），质量和生命长度的相对价值，以及患者-医生咨询的感知内容。结果：328名患者和48名医生完成了调查。患者对治疗结果有很高的期望（例如，实验治疗中位数为60%），选择参加I期试验的患者比拒绝参加I期试验的患者更乐观。患者预测治疗（实验和标准）的获益和不良反应的可能性高于他们的医生（所有比较P < 0.0001）。尽管95%的患者报告生活质量至少与生命长度同等重要，但只有28%的患者报告与医生讨论了治疗后生活质量的变化。相比之下，73%的医生报告讨论了这个话题（P < 0.0001）。结论：参与I期试验的癌症患者对治疗收益的期望超过了他们的医生。患者与医生的认知不一致可能与患者的乐观和自信有关；然而，咨询内容报告的差异，特别是考虑到患者对生活质量的陈述价值，增加了在这种情况下沟通不理想的可能性。(C) 2003年由美国临床肿瘤学会出版。
Purpose : To describe and compare the perceptions of cancer patients and their physicians regarding phase I clinical trials.Methods : Eligible patients had been offered phase I trial participation and had decided to participate but had not yet begun treatment. Each patient's physician also served as a study subject. Patients and physicians completed questionnaires with domains including perceptions of potential benefit and harm from treatment (experimental and standard), relative value of quality and length of life, and perceived content of patient-physician consultations.Results: Three hundred twenty-eight patients and 48 physicians completed surveys. Patients had high expectations regarding treatment outcomes (eg, median 60% benefit from experimental therapy), with those choosing to participate in a phase I trial being more optimistic than those declining phase I participation. Patients predicted a higher likelihood of both benefit and adverse reactions from treatment (experimental and standard) than their physicians (P < .0001 for all comparisons). Although 95% of patients reported that quality of life was at least as important as length of life, only 28% reported that changes in quality of life with treatment were discussed with their physicians. In contrast, 73% of physicians reported that this topic was discussed (P < .0001).Conclusion: Cancer patients offered phase I trial participation have expectations for treatment benefit that exceed those of their physicians. The discordant perceptions of patients and physicians may possibly be explained by patient optimism and confidence; however, the discrepancies in reports of consultation content, particularly given patients' stated values regarding quality of life, raise the possibility that communication in this context is suboptimal. (C) 2003 by American Society of Clinical Oncology.