The influence of non-clinical patient factors on medical oncologists' decisions to recommend breast cancer adjuvant chemotherapy.
The influence of non-clinical patient factors on medical oncologists' decisions to recommend breast cancer adjuvant chemotherapy.
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DOI：
10.1007/s10549-012-2116-3
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发表时间：
2012-07
影响因子：
3.8
通讯作者：
Griggs JJ
中科院分区：
文献类型：
--
作者：
Pini TM;Hawley ST;Li Y;Katz SJ;Griggs JJ
医学肿瘤学家在决定推荐辅助化疗时考虑非临床患者因素的程度尚不清楚。对2005-2007年洛杉矶和底特律监测、流行病学和最终结果登记处报告的早期乳腺癌患者进行治疗的医学肿瘤学家被问及他们在决定推荐辅助化疗时对患者遵循指示的能力、社会支持水平和工作支持/灵活性的重视程度。在李克特5分制中，4分（相当强烈）或5分（非常强烈）的回答定义了强烈的考虑。研究了肿瘤学家/实践特征与对每个非临床因素的强烈考虑之间的关系。134名肿瘤学家（66%）报告强烈考虑一个或多个因素。120名肿瘤学家（59%）强烈认为有能力遵循指示，78名（38%）认为有社会支持，73名（36%）认为有工作支持/灵活性。用于乳腺癌治疗的实践百分比越大，强烈考虑遵循指导能力的可能性越低[优势比（OR） 0.98, 95%可信区间（CI） 0.97-0.99；P = 0.04)。实习年数的增加与强烈考虑社会支持的可能性较低相关（OR 0.96, CI 0.93-0.99； P=0.011），而非白人种族（OR 2.1, CI 1.03-4.26； P=0.041）和肿瘤委员会访问（OR 2.04, CI 1.01-4.12； P=0.048）与高可能性相关。非白人种族与强烈考虑工作支持/灵活性相关（OR 2.44, CI 1.21-4.92； P=0.013）。肿瘤板通路（OR 2, CI 1.00-4.02； P=0.051）具有临界显著性。非临床患者因素在医学肿瘤学家对乳腺癌辅助化疗建议的决策中发挥作用。
The extent to which medical oncologists consider non-clinical patient factors when deciding to recommend adjuvant chemotherapy is unknown. Medical oncologists who treated a population-based sample of early-stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries 2005–2007 were asked how strongly they consider a patient’s ability to follow instructions, level of social support, and level of work support/flexibility in decisions to recommend adjuvant chemotherapy. Responses of 4 (Quite strongly) or 5 (Very strongly) on a 5-point Likert scale defined strong consideration. Associations between oncologist/practice characteristics and strong consideration of each non-clinical factor were examined. 134 oncologists (66%) reported strong consideration of one or more factor. Ability to follow instructions was strongly considered by 120 oncologists (59%), social support by 78 (38%), and work support/flexibility by 73 (36%). Larger percent of practice devoted to breast cancer was associated with lower likelihood of strongly considering ability to follow instructions [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97–0.99; P=0.04]. Increased years in practice was associated with lower likelihood of strongly considering social support (OR 0.96, CI 0.93–0.99; P=0.011), while non-white race (OR 2.1, CI 1.03–4.26; P=0.041) and tumor board access (OR 2.04, CI 1.01–4.12; P=0.048) were associated with higher likelihood. Non-white race was associated with strongly considering work support/flexibility (OR 2.44, CI 1.21–4.92; P=0.013). Tumor board access (OR 2, CI 1.00–4.02; P=0.051) was borderline significant. Non-clinical patient factors play a role in medical oncologist decision-making for breast cancer adjuvant chemotherapy recommendations.
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影响因子：
3
作者：
Katz SJ;Hawley ST;Morrow M;Griggs JJ;Jagsi R;Hamilton AS;Graff JJ;Friese CR;Hofer TP
通讯作者：
Hofer TP
影响因子：
5.9
作者：
Southern, William N.;Bellin, Eran Y.;Arnsten, Julia H.
通讯作者：
Arnsten, Julia H.
影响因子：
45.3
作者：
Keating, Nancy L.;Landrum, Mary Beth;Kahn, Katherine L.
通讯作者：
Kahn, Katherine L.
影响因子：
10.3
作者：
Hawley, Sarah T.;Griggs, Jennifer J.;Katz, Steven J.
通讯作者：
Katz, Steven J.
影响因子：
12.7
作者：
van Ryn, M;Burgess, D;Griffin, J
通讯作者：
Griffin, J