Capsule Commentary on Livaudais, et al., Breast Cancer Treatment Decision-Making: Are We Asking Too Much of Patients?
- Susan George MD, MPH
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Shared decision-making is an increasingly emphasized goal of medicine. While accepted as an aphorism, there are possible negative consequences. The descriptive study by Livaudis et al. explores the consequences of decision making responsibility among women with breast cancer on decision regret; women reporting ‘too much’ responsibility had three-fold greater regret regarding their decision1. Perhaps contributing to this is that women with regret reported insufficient knowledge of treatment benefit. This is similar to findings in another study in which, seven months after surgical intervention, women who preferred more or less decision making responsibility were more regretful.2 It is unclear from either study whether the feelings of regret would change over time.
It is troubling that nearly half of women, regardless of desired degree of decision responsibility, reported occasional or frequent problems understanding written information. Many women also reported insufficient knowledge of
- Livaudais JC, Franco R, Fei K, Bickell NA. Breast cancer treatment decision-making: are we asking too much of patients? J Gen Intern Med. 2013. doi:10.1007/s11606-012-2274-3
- Lantz PM, Janz NJ, Fagerlin A, Schwartz K, Liu L, Lakhani I, Salem B, Katz SJ. Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Services Research. 2005;40(3):745–768. CrossRef
- Politi MC, Studts JL, Hayslip JW. Shared decision making in oncology practice: what do oncologists need to know? Oncologist. 2012;17(1):91–10. CrossRef
- Col NF, Duffy C, Landau C. Commentary—surgical decisions after breast cancer: can patients be too involved in decision making? Health Serv Res. 2005;40(3):769–780. CrossRef
- Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2010;12(5):CD006732.
- Capsule Commentary on Livaudais, et al., Breast Cancer Treatment Decision-Making: Are We Asking Too Much of Patients?
Journal of General Internal Medicine
Volume 28, Issue 5 , p 706
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- 1. Walter Reed National Military Medical Center, 8901 Wisconsin Ave, America Building, 2nd Floor, Bethesda, MD, 20889, USA