Preferences of Patients and Oncologists for Advanced Ovarian Cancer Treatment-Related Health States |
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| Authors: | Lisa M. Hess Daniel C. Malone Pamela G. Reed Grant Skrepnek Karen Weihs |
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| Affiliation: | 1. Center for Cardiovascular and Pulmonary Research, The Research Institute at Nationwide Children''s Hospital, Columbus, OH, United States;2. School of Biomedical Science, The Ohio State University College of Medicine, Columbus, OH, United States;3. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States;4. Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States;1. Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario M4N 3M5, Canada;2. Division of Gynecologic Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario M4N 3M5, Canada;3. The Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Ave., Veterans Hill Trail, Toronto, Ontario M4N 3M5, Canada;4. Department of Obstetrics and Gynaecology, McMaster University, Health Sciences Centre, 1280 Main St. W, 2F43, Hamilton, Ontario L8S 4K1, Canada;5. Division of Gynaecologic Oncology, Princess Margaret Hospital, 610 University Ave., Toronto, Ontario M5G 2M9, Canada;1. Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada;2. University of Calgary, Calgary, Alberta, Canada;3. Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada;4. Calgary Laboratory Services, Calgary, AB, Canada;5. Department of Pathology and Laboratory Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada;6. Department of Oncology, University of Calgary, Tom Baker Cancer Center, Calgary, AB, Canada;7. Translational Laboratory, Tom Baker Cancer Center, Calgary, AB, Canada |
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| Abstract: | PurposeThe purpose of this study was to compare expected utility preferences of various health outcomes of chemotherapy treatment among ovarian-cancer patients receiving chemotherapy, ovarian cancer patients who were post-treatment (eg, under surveillance), and oncologists who treat this disease.MethodsParticipants were asked to score 6 hypothetical ovarian cancer treatment-related health states using both a rating scale and the standard gamble. Scores were obtained in the range of 0.0 (death) to 1.0 (perfect health) for each hypothetical health state, with a difference of 0.10 being practically meaningful, and were analyzed by analysis of variance.ResultsSeventy-five eligible participants were included in this study (41 ovarian-cancer patients and 34 oncologists). Patients and physicians reported similar responses in the rating scale exercise (F = 0.854, P = .43). However, when the health states were presented with an element of uncertainty via the standard gamble exercise, patients who were under surveillance reported significantly different expected utilities of the health states from physicians and from patients who were receiving treatment, demonstrating greater risk aversion than the other groups (F = 4.270, P = .018).ConclusionsThis study suggests that there are significant differences in expected utility preferences among patients who are under surveillance as opposed to oncologists or patients receiving treatment, despite similarities in rating scale values. These findings suggest a need to further evaluate these differences in expected utility preferences in the context of decision in the setting of recurrent disease, where a patient under surveillance must make decisions related to re-initiation of therapy at a time when her preferences are likely to significantly differ from those of oncologists. |
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