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Articles

Are Patients Getting the “Gist” in Risk Communication? Patient Understanding of Prognosis in Breast Cancer Treatment

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Pages 194-199 | Published online: 24 Jun 2009
 

Abstract

Background. Many oncologists consult the Adjuvant! prognostic model to communicate risk with breast cancer patients; however, little is known about how effective that communication is. Methods. The authors analyzed this small data set featuring 20 breast cancer patients' risk estimates, focusing on rankings or gist of the estimates. Results. Overall, there was no gain in the accuracy of patient rankings. The number of patients with more accurate estimates was matched by the number of patients with less accurate estimates after consultation. Conclusions. The current methods used by oncologists to present Adjuvant! risks were not effective in helping patients to get the gist of their risks.

ACKNOWLEDGEMENTS

We thank the patients who participated in the study. We also thank other members of the original study team, including Laura Esserman, Hope Rugo, Debu Tripathy, Fern Hassin, and Daniel Chen. We thank Valerie Reyna for pointing out connections to fuzzy trace theory at the 2007 Summer Institute on Informed Patient Choice. Thanks to Pam Derish for her instruction in scientific writing. Thanks to Brian Jersky for suggesting McNemar's test. Thanks to the staff at the H.M. Fishbon Memorial Library at the University of California, San Francisco, for their assistance with background research and literature searches. Thanks to Martha Daschbach for assistance with regulatory compliance.

Notes

The primary study was funded by the Department of Defense, grant DAMD17-96-1-6260. Funding sources for this secondary analysis included the Department of Defense, DAMD17-96-1-6260, as well the National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) and National Institute of Child Health and Human Development (Grant 9K12HD052163-06). None of the funders had any involvement in the design, conduct, or reporting of this research.

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