The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy
| Autor: | Ken Deal, Natasha B. Leighl, Yvonne Bombard, Maureen E. Trudeau, Karen V. MacDonald, Deborah A. Marshall |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Decision Making Antineoplastic Agents Breast Neoplasms Decisional conflict Decisional Conflict Scale Decision Support Techniques 03 medical and health sciences 0302 clinical medicine Breast cancer chemotherapy Breast cancer Internal medicine medicine Humans 030212 general & internal medicine Stage (cooking) Aged Gynecology business.industry Gene Expression Profiling Middle Aged Microarray Analysis medicine.disease Patient preference Chemotherapy Adjuvant 030220 oncology & carcinogenesis Test score Respondent Female business |
| Zdroj: | European Journal of Cancer. 61:85-93 |
| ISSN: | 0959-8049 |
| Popis: | Background Women with early-stage breast cancer, of whom only 15% will experience a recurrence, are often conflicted or uncertain about taking chemotherapy. Gene expression profiling (GEP) of tumours informs risk prediction, potentially affecting treatment decisions. We examined whether receiving a GEP test score reduces decisional conflict in chemotherapy treatment decision making. Methods A general population sample of 200 women completed the decisional conflict scale (DCS) at baseline (no GEP test score scenario) and after (scenario with GEP test score added) completing a discrete choice experiment survey for early-stage breast cancer chemotherapy. We scaled the 16-item DCS total scores and subscores from 0 to 100 and calculated means, standard deviations and change in scores, with significance (p Results We identified five respondent subgroups based on preferred treatment option; almost 40% did not change their chemotherapy decision after receiving GEP testing information. Total score and all subscores (uncertainty, informed, values clarity, support, and effective decision) decreased significantly in the respondent subgroup who were unsure about taking chemotherapy initially but changed to no chemotherapy (n =33). In the subgroup of respondents (n = 25) who chose chemotherapy initially but changed to unsure, effective decision subscore increased significantly. In the overall sample, changes in total and all subscores were non-significant. Conclusions GEP testing adds value for women initially unsure about chemotherapy treatment with a decrease in decisional conflict. However, for women who are confident about their treatment decisions, GEP testing may not add value. Decisions to request GEP testing should be personalised based on patient preferences. |
| Databáze: | OpenAIRE |
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