Journal of Cancer Education

, 24:194 | Cite as

Are patients getting the “gist” in risk communication? Patient understanding of prognosis in breast cancer treatment

  • David W. Hutton
  • Jeffrey K. Belkora
  • Ross D. Shachter
  • Dan H. Moore

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.

References

  1. 1.
    Ravdin PM, Siminoff LA, Davis GJ, et al. Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. J Clin Oncol. 2001;19:980–991.PubMedGoogle Scholar
  2. 2.
    Olivotto IA, Bajdik CD, Ravdin PM, et al. Population-based validation of the prognostic model adjuvant! For early breast cancer. J Clin Oncol. 2005;23:2716–2725.CrossRefPubMedGoogle Scholar
  3. 3.
    Love N. Management of breast cancer in the adjuvant and metastatic settings. Patterns Care Med Oncol. 2005;2:10–24.Google Scholar
  4. 4.
    Peele PB, Siminoff LA, Xu Y, et al. Decreased use of adjuvant breast cancer therapy in a randomized controlled trial of a decision aid with individualized risk information. Med Decis Making. 2005;25:301–307.CrossRefPubMedGoogle Scholar
  5. 5.
    Brainerd CJ, Reyna VF. Gist is the grist: fuzzy-trace theory and the new intuitionism. Dev Rev. 1990;10:3–47.CrossRefGoogle Scholar
  6. 6.
    Reyna VF, Brainerd CJ. Fuzzy-trace theory: an interim synthesis. Learn Indiv Diff. 1995;7:1–75.CrossRefGoogle Scholar
  7. 7.
    Hegel MT, Moore CP, Collins ED, et al. Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer. Cancer. 2006;107:2924–2931.CrossRefPubMedGoogle Scholar
  8. 8.
    Ahles TA, Saykin AJ, McDonald BC, et al. Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat. 2007;110:143–152.CrossRefPubMedGoogle Scholar
  9. 9.
    Rugo HS, Ahles T. The impact of adjuvant therapy for breast cancer on cognitive function: Current evidence and directions for research. Semin Oncol. 2003;30:749–762.CrossRefPubMedGoogle Scholar
  10. 10.
    Lloyd A, Hayes P, Bell PR, et al. The role of risk and benefit perception in informed consent for surgery. Med Decis Making. 2001;21:141–149.PubMedGoogle Scholar
  11. 11.
    Belkora JK, Rugo HS, Moore DH, et al. Oncologist use of the adjuvant! Model for risk communication: a pilot study examining patient knowledge of 10-year prognosis. BMC Cancer; 2009;9:27. [Epub ahead of print]CrossRefGoogle Scholar
  12. 12.
    McNemar Q. Note on the sampling error of the difference between correlated proportions or percentages. Psychometrika. 1947;12:153–157.CrossRefGoogle Scholar
  13. 13.
    Reyna VF, Adam MB. Fuzzy-trace theory, risk communication, and product labeling in sexually transmitted diseases. Risk Anal. 2003; 23:325–342.CrossRefPubMedGoogle Scholar
  14. 14.
    Gattellari M, Butow PN, Tattersall MH, et al. Misunderstanding in cancer patients: why shoot the messenger? Ann Oncol. 1999; 10:39–46.CrossRefPubMedGoogle Scholar
  15. 15.
    Ravdin PM, Siminoff IA, Harvey JA. Survey of breast cancer patients concerning their knowledge and expectations of adjuvant therapy. J Clin Oncol. 1998;16:515–521.PubMedGoogle Scholar
  16. 16.
    Epstein RM, Alper BS, Quill TE. Communicating evidence for participatory decision making. JAMA. 2004;291:2359–2366.CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2009

Authors and Affiliations

  • David W. Hutton
    • 1
  • Jeffrey K. Belkora
    • 2
  • Ross D. Shachter
    • 1
  • Dan H. Moore
    • 2
  1. 1.Department of Management Science and EngineeringStanford UniversityStanford
  2. 2.University of California, San FranciscoSan Francisco

Personalised recommendations