Breast cancer specialists’ views on and use of risk prediction models in clinical practice: A mixed methods approach

Figures & data

Table I. Participants’ characteristics (N = 51)*.

	Surgeons N (%)	Medical oncologists N (%)
Average age in years (range)	50 (37–64)	48 (31–62)
Age unknown	8 (32)	5 (19)
Gender
Male	12 (71)	10 (48)
Experience with breast cancer care in years
< 5	5 (20)	10 (39)
6–10	9 (36)	9 (35)
> 10	11 (44)	7 (27)
Number of consultations with early-stage breast cancer patients per month
1–5	1 (4)	3 (12)
6–10	7 (7)	12 (46)
> 10	17 (68)	11 (42)
Type of hospital
General teaching hospital	10 (59)	12 (55)
University medical center	4 (24)	6 (27)
General non-teaching hospital	3 (18)	4 (18)
Total	25 (49)	26 (51)

*Participants do not add up to 51 due to missing data.

No significant differences between surgical and medical oncologists, hence p-values not reported.

Table II. Frequency of RPM use (in N (%)).

	Surgeons N = 24*	Medical oncologists N = 25*	P^#
Never	4 (17)	0	0.007
Ever	3 (13)	0
Sometimes	9 (38)	7 (28)
Regularly	8 (33)	18 (72)

*Participants do not add up to 51 due to missing data.

^#Comparison made using Fisher's exact test.

Table III. Oncologists’ views on using Adjuvant! Online (AO) during the consultation (in %).

Oncologists should:		Surgical oncologists (N = 19^$)			Medical oncologists (N = 24^$)
		Disagree	Neutral	Agree	Disagree	Neutral	Agree
A	not show AO estimates to patients as it is too difficult for them	84	16	0	83	17	0
B	not show AO estimates to patients as people cling too much to the estimates	53	47	0	75	21	4
C	never show AO estimates to patients, it is best to use verbal labels^# instead	42	42	16	71	21	8
D	not show AO estimates to patients if these estimates are too hard to face	47	32	21	63	12	25
E	only show AO estimates to highly educated patients as they are best capable of understanding this information	63	21	16	83	12	4
F	offer to show AO estimates to patients and show the estimates if the patient wants to see it	16	10	74	17	20	63
G	always show AO estimates, unless the patient absolutely does not want to hear this	53	26	21	79	8	13
H	always show AO estimates to breast cancer patients ≤ 40 years, as this information is most relevant for these patients	53	36	11	71	16	13
I	always show AO estimates if the patient asks for information on prognosis	0	32	68	17	8	75

^$Participants do not add up to 51 due to missing data.

^#Verbal labels are terms used to denote likelihoods, e.g. “small chance that x will happen” or “it is likely that x will happen”.

The category “disagree” comprises of those that selected either “totally disagree” or “disagree”. And the category ”agree” comprises of those that selected either “agree” or “totally agree”.

No significant differences between surgical and medical oncologists were found, hence p-values Fisher's exact test are not reported.

Table IV. Oncologists’ reasons for using Adjuvant! Online (AO) (in %).

		Surgical oncologists (N = 19^$)					Medical oncologists (N = 24^$)
		Never	Rarely	Sometimes	Often	Always	Never	Rarely	Sometimes	Often	Always	P#
Oncologists use AO before the consultation to:
A	prepare for the consultation	11	21	37	26	5	8	8	25	33	25	0.371
Oncologists use AO during the consultation to:
B	inform patients	16	16	53	16	0	0	0	38	50	13	0.003
C	inform patients who ask about prognosis	16	16	26	37	5	0	4	21	54	21	0.099
D	present the survival probabilities graphically	16	16	47	11	11	4	30	22	39	4	0.070
E	convince patients that undergoing chemotherapy is not necessary	42	11	26	21	0	4	21	63	8	4	0.006
F	help patients decide whether or not to undergo chemotherapy	21	5	47	26	0	4	4	25	63	4	0.050
G	convince patients of the benefits of my treatment plan	32	5	42	21	0	0	17	58	21	4	0.024

^$Participants do not add up to 51 due to missing data.

^#Comparison made using Fisher's exact test.

Not significant.