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10.1245/ASO.2006.03.086
Annals of Surgical Oncology 13:86-95 (2006)
© 2006 Society of Surgical Oncology
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Original Article

Method of Presenting Oncology Treatment Outcomes Influences Patient Treatment Decision-Making in Metastatic Colorectal Cancer

Robert C. G. Martin, II, MD1, Sheri A. McGuffin, MAE3, Lynne M. Roetzer, BA3, Troy D. Abell, PhD, MPH4 and Jamie L. Studts, PhD2

1 Division of Surgical Oncology, University of Louisville School of Medicine, 315 East Broadway, Room 313, Louisville, Kentucky 40202
2 Department of Medicine and Behavioral Oncology Program, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, Kentucky 40202
3 Department of Psychological and Brain Sciences, University of Louisville School of Medicine, Louisville, Kentucky 40202
4 Abell Research Consulting, Ouray, Colorado 81427

Correspondence: Address correspondence and reprint requests to: Robert C. G. Martin II, MD; E-mail: robert.martin{at}louisville.edu.

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.

Key Words: Decision analysis • Metastatic colorectal cancer • Chemotherapy • Surgery






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