Adjuvant chemotherapy for breast cancer: How presentation of recurrence risk influences decision-making
Adjuvant chemotherapy for breast cancer: How presentation of recurrence risk influences decision-making
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DOI：
10.1200/jco.2003.06.025
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发表时间：
2003-12-01
影响因子：
45.3
通讯作者：
McMasters, KM
中科院分区：
文献类型：
--
作者：
Chao, C;Studts, JL;McMasters, KM
目的：本研究的目的是检查四种沟通生存获益的方法对化疗决策的影响。我们假设这四种沟通数学上相等的风险信息的方法会导致不同的化疗决策。方法：每位参与者收到两种关于其母亲的假设情景（一名绝经后患有侵袭性，淋巴结阴性，激素受体阳性乳腺癌的妇女），并被要求决定是否鼓励其母亲在手术和他莫昔芬的基础上接受化疗。在第一部分中，参与者接受了四种描述化疗生存获益的方法之一：(1)相对风险降低，(2)绝对风险降低，(3)绝对生存获益，或(4)需要治疗的数量。在第2部分中，每个参与者都接受了所有四种方法。在每个决定之后，参与者被要求评估他们对自己决定的信心和困惑程度。结果：研究对象包括203名临床前医学院学生。在第一部分中，接受相对风险降低信息的参与者更有可能支持化疗。在第2部分中，当参与者接受所有四种沟通化疗生存益处的方法时，没有治疗决策差异。然而，接受所有四种方法导致明显更高的混乱评级。在决定是否支持化疗时，当提供绝对生存获益格式的数据时，参与者对信息的理解最好。结论：这些结果支持了这样的假设，即用于呈现化疗信息的方法会影响治疗决策。绝对生存获益是传达治疗获益信息的最容易理解的方法。(C) 2003年由美国临床肿瘤学会出版。
Purpose: The purpose of this study was to examine the impact of four methods of communicating survival benefits on chemotherapy decisions. We hypothesized that the four methods of communicating mathematically equivalent risk information would lead to different chemotherapy decisions.Methods: Each participant received two hypothetical scenarios regarding their mother (a postmenopausal woman with an invasive, lymph node-negative, hormone receptor-positive breast cancer) and was asked to decide whether they would encourage their mother to take chemotherapy in addition to surgery and tamoxifen. In the part 1, participants received one of four methods of describing the chemotherapy survival benefit: (1) relative risk reduction, (2) absolute risk reduction, (3) absolute survival benefit, or (4) number needed to treat. In part 2, each participant received all four methods. Following each decision, participants were asked to rate their confidence and confusion regarding their decision.Results: Participants included 203 preclinical medical students. In part 1, participants who received relative risk reduction information were significantly more likely to endorse chemotherapy. In part 2, there were no treatment decision differences when participants received all four methods of communicating survival benefits of chemotherapy. However, receiving all four methods led to significantly higher ratings of confusion. In deciding on endorsing chemotherapy, participants understood the information best when presented with data in the absolute survival benefit format.Conclusion: These results support the hypothesis that the method used to present information about chemotherapy influences treatment decisions. Absolute survival benefit is the most easily understood method of conveying the information regarding benefit of treatment. (C) 2003 by American Society of Clinical Oncology.