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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Bond M, Bicknell M, Crump T, Penner M, Veljkovic A, Wing K, Younger A, Liu G, Sutherland JM. Shared Decision Making in Hallux Valgus Surgery: A Prospective Observational Study. J Patient Exp 2024; 11:23743735241229376. [PMID: 38313865 PMCID: PMC10836134 DOI: 10.1177/23743735241229376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
Patient-physician communication has the potential to improve outcomes and satisfaction through the shared decision-making process (SDM). This study aims to assess the relationship between perception of SDM and demographic, clinical, and patient-reported outcomes in patients undergoing Hallux Valgus (HV) correction. A prospective analysis of 306 patients scheduled for HV surgery was completed. The CollaboRATE score was used to measure SDM. Multivariable linear regression model was used to assess whether SDM scores were associated with preoperative characteristics or postoperative outcome scores. The mean CollaboRATE score was 2.9 (SD 0.9) and did not differ by age, socioeconomic status, or sex. Lower CollaboRATE scores were associated with more symptoms of depression, lower socioeconomic status, and lower general health scores (p-value < 0.05). There was no association between SDM scores and postoperative outcome scores. In this study, patients with depressive symptoms and lower socioeconomic status had worse perceptions of SDM. There was no difference in postoperative outcomes among participants based on SDM scores. Level of Evidence: Level III, prospective observational study.
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Affiliation(s)
- Michael Bond
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | - Mattheus Bicknell
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | - Trafford Crump
- Faculty of Medicine, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Murray Penner
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Veljkovic
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin Wing
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alastair Younger
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Guiping Liu
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
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3
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Wiener AA, Hanlon BM, Schumacher JR, Vande Walle KA, Wilke LG, Neuman HB. Reexamining Time From Breast Cancer Diagnosis to Primary Breast Surgery. JAMA Surg 2023; 158:485-492. [PMID: 36857045 PMCID: PMC9979003 DOI: 10.1001/jamasurg.2022.8388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/27/2022] [Indexed: 03/02/2023]
Abstract
Importance Although longer times from breast cancer diagnosis to primary surgery have been associated with worse survival outcomes, the specific time point after which it is disadvantageous to have surgery is unknown. Identifying an acceptable time to surgery would help inform patients, clinicians, and the health care system. Objective To examine the association between time from breast cancer diagnosis to surgery (in weeks) and overall survival and to describe factors associated with surgical delay. The hypothesis that there is an association between time to surgery and overall survival was tested. Design, Setting, and Participants This was a case series study that used National Cancer Database (NCDB) data from female individuals diagnosed with breast cancer from 2010 to 2014 (with 5-year follow-up to 2019). The NCDB uses hospital registry data from greater than 1500 Commission on Cancer-accredited facilities, accounting for 70% of all cancers diagnosed in the US. Included participants were females 18 years or older with stage I to III ductal or lobular breast cancer who underwent surgery as the first course of treatment. Patients with prior breast cancer, missing receptor information, neoadjuvant or experimental therapy, or who were diagnosed with breast cancer on the date of their primary surgery were excluded. Multivariable Cox regression was used to evaluate factors associated with overall survival. Patients were censored at death or last follow-up. Covariates included age and tumor characteristics. Multinomial regression was performed to identify factors associated with longer time to surgery, using surgery 30 days or less from diagnosis as the reference group. Data were analyzed from March 15 to July 7, 2022. Exposures Time to receipt of primary breast surgery. Measures The primary outcome measure was overall survival. Results The final cohort included 373 334 patients (median [IQR] age, 61 [51-70] years). On multivariable Cox regression analysis, time to surgery 9 weeks (57-63 days) or later after diagnosis was associated with worse overall survival (hazard ratio, 1.15; 95% CI, 1.08-1.23; P < .001) compared with surgery between 0 to 4 weeks (1-28 days). By multinomial regression, factors associated with longer times to surgery (using surgery 1-30 days from diagnosis as a reference) included the following: (1) younger age, eg, the adjusted odds ratio (OR) for patients 45 years or younger undergoing surgery 31 to 60 days from diagnosis was 1.32 (95% CI, 1.28-1.38); 61 to 74 days, 1.64 (95% CI, 1.52-1.78); and greater than 74 days, 1.58 (95% CI, 1.46-1.71); (2) uninsured or Medicaid status, eg, the adjusted OR for patients with Medicaid undergoing surgery 31 to 60 days from diagnosis was 1.35 (95% CI, 1.30-1.39); 61 to 74 days, 2.13 (95% CI, 2.01-2.26); and greater than 74 days, 3.42 (95% CI, 3.25-3.61); and (3) lower neighborhood household income, eg, the adjusted OR for patients with household income less than $38,000 undergoing surgery 31 to 60 days from diagnosis was 1.35 (95% CI, 1.02-1.07); 61 to 74 days, 1.21 (95% CI, 1.15-1.27); and greater than 74 days, 1.53 (95% CI, 1.46-1.61). Conclusions and Relevance Findings of this case series study suggest the use of 8 weeks or less as a quality metric for time to surgery. Time to surgery of greater than 8 weeks may partly be associated with disadvantageous social determinants of health.
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Affiliation(s)
- Alyssa A. Wiener
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - Bret M. Hanlon
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Jessica R. Schumacher
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison
| | - Kara A. Vande Walle
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - Lee G. Wilke
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison
| | - Heather B. Neuman
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison
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Current Considerations in Surgical Treatment for Adolescents and Young Women with Breast Cancer. Healthcare (Basel) 2022; 10:healthcare10122542. [PMID: 36554065 PMCID: PMC9777860 DOI: 10.3390/healthcare10122542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Adolescents and young women (AYA) with breast cancer represent a unique patient population, compared to the general population with breast cancer. We performed a literature review to evaluate the factors that influenced the surgical outcomes in this patient population. Fifty-two studies were identified, which evaluated breast surgery type, axillary surgery, contralateral prophylactic mastectomy (CPM), surgical timing, psychological factors, disparities, and imaging use. AYA patients had equivalent oncologic outcomes with breast conserving surgery (BCS) or mastectomy. CPM did not improve survival. There are limited data on axillary management in the AYA population, and while more data would be beneficial, this is currently extrapolated from the general breast cancer population. A shorter time to initiate treatment correlated to better outcomes, and disparities need to be overcome for optimal outcomes. AYA patients appreciated involvement in clinical decisions, and shared decision making should be considered whenever possible. Providers must keep these factors in mind when counseling AYA patients, regarding the surgical management of breast cancer.
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Keij SM, de Boer JE, Stiggelbout AM, Bruine de Bruin W, Peters E, Moaddine S, Kunneman M, Pieterse AH. How are patient-related characteristics associated with shared decision-making about treatment? A scoping review of quantitative studies. BMJ Open 2022; 12:e057293. [PMID: 35613791 PMCID: PMC9174801 DOI: 10.1136/bmjopen-2021-057293] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To identify what patient-related characteristics have been reported to be associated with the occurrence of shared decision-making (SDM) about treatment. DESIGN Scoping review. ELIGIBILITY CRITERIA Peer-reviewed articles in English or Dutch reporting on associations between patient-related characteristics and the occurrence of SDM for actual treatment decisions. INFORMATION SOURCES COCHRANE Library, Embase, MEDLINE, PsycInfo, PubMed and Web of Science were systematically searched for articles published until 25 March 2019. RESULTS The search yielded 5289 hits of which 53 were retained. Multiple categories of patient characteristics were identified: (1) sociodemographic characteristics (eg, gender), (2) general health and clinical characteristics (eg, symptom severity), (3) psychological characteristics and coping with illness (eg, self-efficacy) and (4) SDM style or preference. Many characteristics showed no association or unclear relationships with SDM occurrence. For example, for female gender positive, negative and, most frequently, non-significant associations were seen. CONCLUSIONS A large variety of patient-related characteristics have been studied, but for many the association with SDM occurrence remains unclear. The results will caution often-made assumptions about associations and provide an important step to target effective interventions to foster SDM with all patients.
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Affiliation(s)
- Sascha M Keij
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Joyce E de Boer
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne M Stiggelbout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Wändi Bruine de Bruin
- Schaeffer Center for Health Policy and Economics, Dornsife Department of Psychology, and Price School of Public Policy, University of Southern California, Los Angeles, California, USA
| | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
| | - Saïda Moaddine
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Marleen Kunneman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Arwen H Pieterse
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
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6
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Boaz H, Shuli BG. Involvement levels of breast cancer patients-Seeking trusted hospital and physician. J Health Psychol 2021; 27:2603-2612. [PMID: 34875916 DOI: 10.1177/13591053211062350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The active involvement levels of breast cancer patients (BCP) in treatment decisions range from 10% to 81%. We investigated the involvement levels of 179 Israeli breast cancer survivors, aged 30 to 81, in the choice of hospital, surgeon, surgical procedure, chemotherapy, and radiotherapy. High involvement was documented in location decisions (operating hospital 77%, chemotherapy facility 82%) as opposed to low involvement in treatment decisions (chemotherapy 30%-38%, radiotherapy 25%, surgical procedure 31%). Involvement was influenced by hospital and surgeon reputation, education level, and income. BCPs actively choose their treating facility and staff, and then follow their doctor's recommendations.
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Affiliation(s)
- Hovav Boaz
- The Max Stern Yezreel Valley College, Israel.,University of Haifa School of Public Health, Israel
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Noteboom EA, May AM, van der Wall E, de Wit NJ, Helsper CW. Patients' preferred and perceived level of involvement in decision making for cancer treatment: A systematic review. Psychooncology 2021; 30:1663-1679. [PMID: 34146446 PMCID: PMC8518833 DOI: 10.1002/pon.5750] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/28/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patient involvement in decision making is conditional for personalised treatment decisions. We aim to provide an up-to-date overview of patients' preferred and perceived level of involvement in decision making for cancer treatment. METHODS A systematic search was performed in PubMed, EMBASE, PsycINFO and CINAHL for articles published between January 2009 and January 2020. Search terms were 'decision making', 'patient participation', 'oncology', 'perception' and 'treatment'. Inclusion criteria were: written in English, peer-reviewed, reporting patients' preferred and perceived level of involvement, including adult cancer patients and concerning decision making for cancer treatment. The percentages of patients preferring and perceiving an active, shared or passive decision role and the (dis)concordance are presented. Quality assessment was performed with a modified version of the New-Castle Ottawa Scale. RESULTS 31 studies were included. The median percentage of patients preferring an active, shared or passive role in decision making was respectively 25%, 46%, and 27%. The median percentage of patients perceiving an active, shared or passive role was respectively 27%, 39%, and 34%. The median concordance in preferred and perceived role of all studies was 70%. Disconcordance was highest for a shared role; 42%. CONCLUSIONS Patients' preferences for involvement in cancer treatment decision vary widely. A significant number of patients perceived a decisional role other than preferred. Improvements in patient involvement have been observed in the last decade. However, there is still room for improvement and physicians should explore patients' preferences for involvement in decision making in order to truly deliver personalised cancer care.
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Affiliation(s)
- Eveline A. Noteboom
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Anne M. May
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Elsken van der Wall
- Department: Medical OncologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Niek J. de Wit
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Charles W. Helsper
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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Shinkunas LA, Klipowicz CJ, Carlisle EM. Shared decision making in surgery: a scoping review of patient and surgeon preferences. BMC Med Inform Decis Mak 2020; 20:190. [PMID: 32787950 PMCID: PMC7424662 DOI: 10.1186/s12911-020-01211-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Many suggest that shared decision-making (SDM) is the most effective approach to clinical counseling. It is unclear if this applies to surgical decision-making-especially regarding urgent, highly-morbid operations. In this scoping review, we identify articles that address patient and surgeon preferences toward SDM in surgery. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) to develop our protocol. Medline, EMBASE, and Cochrane databases were searched from inception through 11.2017. Title/abstract review identified peer-reviewed, empirical articles that addressed patient/surgeon preferences toward SDM in surgery. Identified articles underwent full review by two independent investigators. We addressed the following questions: (1) What is known from existing empirical evidence about patients’ and/or surgeons’ surgical decision-making preferences? (2) Why might patients and/or surgeons prefer SDM? (3) Does acuity of intervention impact surgical decision-making preferences? Outcome measures included study methods, surgical specialty, diagnosis, study location/setting, type/number of subjects, acuity of intervention, surgeon/patient decision-making preferences, and factors associated with favoring SDM. Data was analyzed in Microsoft Excel. Results 20,359 articles were identified with 4988 duplicates, yielding 15,371 articles for title/abstract review. 74 articles were included in final analysis. 68% of articles discussed oncologic decision-making. 46% of these focused on breast cancer. 92% of articles included patients, 22% included surgeons. 75% of articles found surgeons favored SDM, 25% demonstrated surgeons favored surgeon guidance. 54% of articles demonstrated patients favored SDM, 35% showed patients favored surgeon guidance, 11% showed patients preferred independent decision-making. The most common factors for patients favoring SDM included female gender, higher education, and younger age. For surgeons, the most common factors for favoring SDM included limited evidence for a given treatment plan, multiple treatment options, and impact on patient lifestyle. No articles evaluated decision-making preferences in an emergent setting. Conclusions There has been limited evaluation of patient and surgeon preferences toward SDM in surgical decision-making. Generally, patients and surgeons expressed preference toward SDM. None of the articles evaluated decision-making preferences in an emergent setting, so assessment of the impact of acuity on decision-making preferences is limited. Extension of research to complex, emergent clinical settings is needed.
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Affiliation(s)
- Laura A Shinkunas
- Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, USA
| | | | - Erica M Carlisle
- Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, USA. .,Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA.
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Sepucha KR, Langford AT, Belkora JK, Chang Y, Moy B, Partridge AH, Lee CN. Impact of Timing on Measurement of Decision Quality and Shared Decision Making: Longitudinal Cohort Study of Breast Cancer Patients. Med Decis Making 2019; 39:642-650. [PMID: 31354095 PMCID: PMC7240785 DOI: 10.1177/0272989x19862545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose.The objective of this study was to examine whether scores of shared decision-making measures differ when collected shortly after (1 month) or long after (1 year) breast cancer surgical treatment decisions. Methods. Longitudinal, multisite survey of breast cancer (BC) patients, with measurements at 1 month and 1 year after surgery at 4 cancer centers. Patients completed the BC Surgery Decision Quality Instrument (used to generate a knowledge score, ratings of goals, and concordance with treatment preferences) and Shared Decision Making (SDM) Process survey at both time points. We tested several hypotheses related to the scores over time, including whether the scores discriminated between sites that did and did not offer formal decision support services. Exploratory analyses examined factors associated with large increases and decreases in scores over time. Results. Across the 4 sites, 229 patients completed both assessments. The mean total knowledge scores (69.2% [SD 16.6%] at 1 month and 69.4% [SD 17.7%] at 1 year, P = 0.86), SDM Process scores (2.7 [SD 1.1] 1 month v. 2.7 [SD 1.2] 1 year, P = 0.68), and the percentage of patients receiving their preferred treatment (92% at 1 month and 92% at 1 year, P = 1.0) were not significantly different over time. The site using formal decision support had significantly higher knowledge and SDM Process scores at 1 month, and only the SDM Process scores remained significantly higher at 1 year. A significant percentage of patients had large changes in their individual knowledge and SDM Process scores, with increases balancing out decreases. Conclusion. For population-level assessments, it is reasonable to survey BC patients up to a year after the decision, greatly increasing feasibility of measurement. For those evaluating decision support interventions, shorter follow-up is more likely to detect an impact on knowledge scores.
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Affiliation(s)
- Karen R Sepucha
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aisha T Langford
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, NYU School of Medicine, New York, NY, USA
| | | | - Yuchiao Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Beverly Moy
- Division of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Clara N Lee
- The Ohio State University, Columbus, OH, USA
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de Mik SML, Stubenrouch FE, Balm R, Ubbink DT. Systematic review of shared decision-making in surgery. Br J Surg 2018; 105:1721-1730. [PMID: 30357815 PMCID: PMC6282808 DOI: 10.1002/bjs.11009] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/08/2018] [Accepted: 09/05/2018] [Indexed: 12/21/2022]
Abstract
Background Multiple treatment options are generally available for most diseases. Shared decision‐making (SDM) helps patients and physicians choose the treatment option that best fits a patient's preferences. This review aimed to assess the extent to which SDM is applied during surgical consultations, and the metrics used to measure SDM and SDM‐related outcomes. Methods This was a systematic review of observational studies and clinical trials that measured SDM during consultations in which surgery was a treatment option. Embase, MEDLINE and CENTRAL were searched. Study selection, quality assessment and data extraction were conducted by two investigators independently. Results Thirty‐two articles were included. SDM was measured using nine different metrics. Thirty‐six per cent of 13 176 patients and surgeons perceived their consultation as SDM, as opposed to patient‐ or surgeon‐driven. Surgeons more often perceived the decision‐making process as SDM than patients (43·6 versus 29·3 per cent respectively). SDM levels scored objectively using the OPTION and Decision Analysis System for Oncology instruments ranged from 7 to 39 per cent. Subjective SDM levels as perceived by surgeons and patients ranged from 54 to 93 per cent. Patients experienced a higher level of SDM during consultations than surgeons (93 versus 84 per cent). Twenty‐five different SDM‐related outcomes were reported. Conclusion At present, SDM in surgery is still in its infancy, although surgeons and patients both think of it favourably. Future studies should evaluate the effect of new interventions to improve SDM during surgical consultations, and its assessment using available standardized and validated metrics. Heterogeneous data
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Affiliation(s)
- S M L de Mik
- Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F E Stubenrouch
- Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R Balm
- Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - D T Ubbink
- Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Palmer Kelly E, Agne JL, Meara A, Pawlik TM. Reciprocity within patient-physician and patient-spouse/caregiver dyads: insights into patient-centered care. Support Care Cancer 2018; 27:1237-1244. [DOI: 10.1007/s00520-018-4482-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
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12
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Herrmann A, Hall A, Sanson-Fisher R, Zdenkowski N, Watson R, Turon H. Not asking cancer patients about their preferences does make a difference. A cross-sectional study examining cancer patients' preferred and perceived role in decision-making regarding their last important cancer treatment. Eur J Cancer Care (Engl) 2018; 27:e12871. [PMID: 29900611 DOI: 10.1111/ecc.12871] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/04/2018] [Accepted: 05/05/2018] [Indexed: 11/26/2022]
Abstract
We examined whether not having been asked by their clinicians about how involved cancer patients would like to be in their treatment decisions is related to discordance between patients' preferred and perceived involvement in treatment decision-making. This was a cross-sectional survey of adult cancer patients recruited from five medical and radiation oncology outpatient clinics in Australia. Discordance of patients' preferred and perceived decision-making roles was assessed via an adapted version of the Control Preferences Scale. Logistic regression modelling was conducted to assess the relationship between role discordance and whether patients were not asked but wanted to be asked about how involved they would like to be in deciding on their treatment. Of 423 study participants, almost a third (n = 128, 31%) reported discordance between their preferred and perceived involvement in their treatment decisions. Of those reporting discordance, 72% (n = 92) were less involved than they would have liked to have been. Not being asked about their preferences for involvement in treatment decisions, despite wanting this, was associated with discordance between patients' preferred and perceived involvement in treatment decision-making (p < 0.04). To achieve patient-centred care, it is vital that clinicians seek patients' views about how involved they would like to be in deciding on their cancer treatment.
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Affiliation(s)
- Anne Herrmann
- Priority Research Centre for Health Behaviour, University of Newcastle/Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Alix Hall
- Priority Research Centre for Health Behaviour, University of Newcastle/Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Rob Sanson-Fisher
- Priority Research Centre for Health Behaviour, University of Newcastle/Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Nicholas Zdenkowski
- Department of Medical Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
| | - Rochelle Watson
- Priority Research Centre for Health Behaviour, University of Newcastle/Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Heidi Turon
- Priority Research Centre for Health Behaviour, University of Newcastle/Hunter Medical Research Institute, Callaghan, NSW, Australia
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Jiang Y, Sereika SM, Bender CM, Brufsky AM, Rosenzweig MQ. Beliefs in Chemotherapy and Knowledge of Cancer and Treatment Among African American Women With Newly Diagnosed Breast Cancer. Oncol Nurs Forum 2017; 43:180-9. [PMID: 26906129 DOI: 10.1188/16.onf.180-189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine beliefs regarding the necessity of chemotherapy and knowledge of breast cancer and its treatment in African American women with newly diagnosed breast cancer, and to explore factors associated with women's beliefs and knowledge.
. DESIGN Descriptive, cross-sectional study.
. SETTING Six urban cancer centers in Western Pennsylvania and Eastern Ohio.
. SAMPLE 101 African American women with newly diagnosed breast cancer.
. METHODS Secondary analysis using baseline data collected from participants in a randomized, controlled trial at their first medical oncology visit before the first cycle of chemotherapy.
. MAIN RESEARCH VARIABLES Belief in chemotherapy, knowledge of cancer and recommended treatment, self-efficacy, healthcare system distrust, interpersonal processes of care, symptom distress, and quality of life.
. FINDINGS African American women endorsed the necessity of chemotherapy. Most women did not know their tumor size, hormone receptors, specific therapy, or why chemotherapy was recommended to them. Women who perceived better interpersonal communication with physicians, less self-efficacy, or were less involved in their own treatment decision making held stronger beliefs about the necessity of chemotherapy. Women without financial difficulty or having stronger social functioning had more knowledge of their cancer and recommended chemotherapy.
. CONCLUSIONS African American women with newly diagnosed breast cancer generally agreed with the necessity of chemotherapy. Knowledge of breast cancer, treatment, and risk reduction through adjuvant therapy was limited.
. IMPLICATIONS FOR NURSING Oncology nurses could help advocate for tailored educational programs to support informed decision making regarding chemotherapy acceptance for African American women.
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Affiliation(s)
- Yun Jiang
- University of Michigan School of Nursing in Ann Arbor
| | - Susan M Sereika
- Associate professors School of Nursing, University of Pittsburgh, Pennsylvania
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14
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Participation in treatment decision-making among Chinese-Australian women with breast cancer. Support Care Cancer 2016; 25:957-963. [DOI: 10.1007/s00520-016-3487-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/07/2016] [Indexed: 11/27/2022]
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15
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Turkman YE, Kennedy HP, Harris LN, Knobf MT. "An addendum to breast cancer": the triple negative experience. Support Care Cancer 2016; 24:3715-21. [PMID: 27037812 DOI: 10.1007/s00520-016-3184-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 03/21/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE The triple negative breast cancer (TNBC) subtype, known to be aggressive with high recurrence and mortality rates, disproportionately affects African-Americans, young women, and BRCA1 carriers. TNBC does not respond to hormonal or biologic agents, limiting treatment options. The unique characteristics of the disease and the populations disproportionately affected indicate a need to examine the responses of this group. No known studies describe the psychosocial experiences of women with TNBC. The purpose of this study is to begin to fill that gap and to explore participants' psychosocial needs. METHOD An interpretive descriptive qualitative approach was used with in-depth interviews. A purposive sample of adult women with TNBC was recruited. Dominant themes were extracted through iterative and constant comparative analysis. RESULTS Of the 22 participants, nearly half were women of color, and the majority was under the age of 60 years and within 5 years of diagnosis. The central theme was a perception of TNBC as "an addendum" to breast cancer. There were four subthemes: TNBC is Different: "Bottom line, it's not good"; Feeling Insecure: "Flying without a net"; Decision-Making and Understanding: "A steep learning curve"; and Looking Back: "Coulda, shoulda, woulda." Participants expressed a need for support in managing intense uncertainty with a TNBC diagnosis and in decision-making. CONCLUSIONS Women with all subtypes of breast cancer have typically been studied together. This is the first study on the psychosocial needs specifically of women with TNBC. The findings suggest that women with TNBC may have unique experiences and unmet psychosocial needs.
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Affiliation(s)
- Yasemin E Turkman
- University of Virginia School of Nursing, 202 Lancaster Way, Charlottesville, VA, 22903, USA.
| | | | - Lyndsay N Harris
- Division of Hematology/Oncology, Department of Medicine, Case Western University Medical School, Cleveland, OH, 44106, USA
| | - M Tish Knobf
- Yale School of Nursing in West Haven, West Haven, CT, USA
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16
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Pan HH, Chu CH, Wu LF, Hsieh PC, Chang KC, Li CY. Predictors for Reconstruction and Mood Disorder Associated With Reconstruction in Patients With Breast Cancer and Mastectomy: A Retrospective Cohort Study. Medicine (Baltimore) 2016; 95:e2510. [PMID: 26817890 PMCID: PMC4998264 DOI: 10.1097/md.0000000000002510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study used Taiwan's National Health Insurance medical claims to investigate the predictors for operative modes chosen by early-stage breast cancer patients; as well as to assess whether operative modes are associated with risk of mood disorder. We included 36,377 patients with breast cancer who received surgery between 2000 and 2008, and were followed to the end of 2010; they were further classified into 3 groups: mastectomy alone (n = 34,900), along with early reconstruction (n = 1080), and along with delayed reconstruction (n = 397). The results showed that age, insurance premium, urbanization level, and postsurgery chemotherapy and radiotherapy were all significant predictors for the selection of operative modes. Breast cancer patients with mastectomy alone, early reconstruction, and delayed reconstruction showed a cumulative incidence rate of mood disorder of 36.90%, 41.56%, and 33.89%, respectively. The multiple cox proportional model further revealed that early (hazard ratio [HR] = 1.06, 95% confidence interval (CI) = 0.93-1.21) and delayed (HR = 1.17, 95% CI = 0.96-1.42) reconstruction were associated with a slightly higher but insignificant risk of mood disorder, as compared to the patients received no reconstruction.
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Affiliation(s)
- Hsueh-Hsing Pan
- From the School of Nursing, National Defense Medical Center, Taipei, Taiwan (H-HP, L-FW); Department and Institute of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan (C-HC, K-CC, C-YL); Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan (L-FW); Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan (P-CH); Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan (K-CC); and Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (C-YL)
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17
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18
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Ben Charif A, Bouhnik AD, Rey D, Provansal M, Courbiere B, Spire B, Mancini J. Satisfaction with fertility- and sexuality-related information in young women with breast cancer--ELIPPSE40 cohort. BMC Cancer 2015; 15:572. [PMID: 26239242 PMCID: PMC4523948 DOI: 10.1186/s12885-015-1542-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 07/13/2015] [Indexed: 11/25/2022] Open
Abstract
Background Young breast cancer survivors are often dissatisfied with the information provided on fertility and sexuality. Our aim was to discuss possible contributing factors and to propose strategies to increase patient satisfaction with such information. Methods Using the French National Health Insurance System database, we constituted the ELIPPSE40 regional cohort of 623 women, aged 18–40, diagnosed with breast cancer between 2005 and 2011. As of January 2014, 319 women had taken part in the 10-, 16-, 28 and 48-month telephone interviews. Satisfaction with the information provided about the potential impact of cancer and its treatment on fertility and sexuality was assessed at 48 months after diagnosis on 5-point Likert scales. Results Four years after diagnosis, only 53.0 and 42.6 % of women were satisfied with fertility- and sexuality-related information, respectively, without any significant change over the 2009–2014 period (P = 0.585 and P = 0.676 respectively). The two issues were moderately correlated (ρ = 0.60; P <0.001). General satisfaction with medical follow-up was the only common correlate. Irrespective of sociodemographic and medical characteristics, satisfaction with fertility-related information was greater among women with a family history of breast/ovarian cancer who had the opportunity to ask questions at the time of cancer disclosure. Satisfaction with sexuality-related information increased with the spontaneous provision of information by physicians at cancer disclosure. Conclusions Promoting both patients’ question asking behavior and more systematic information could improve communication between caregivers and young breast cancer survivors and address distinct unmet needs regarding fertility- and sexuality- related information. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1542-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ali Ben Charif
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Anne-Déborah Bouhnik
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France.
| | - Dominique Rey
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Magali Provansal
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,Institut Paoli-Calmettes, Marseille, France.
| | - Blandine Courbiere
- IMBE UMR7263, Aix Marseille Université, CNRS, IRD, Avignon Université, Marseille, France. .,Department of Obstetrics, Gynecology and Reproductive Medicine, APHM, La Conception Hospital, Marseille, France.
| | - Bruno Spire
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Julien Mancini
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,BiosTIC, La Timone Hospital, APHM, Marseille, France. .,UMR912, SESSTIM, "Cancers, Biomedicine & Society" group, Institut Paoli-Calmettes, 232 Bd Ste Marguerite, 13273, Marseille, France.
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Hess EP, Grudzen CR, Thomson R, Raja AS, Carpenter CR. Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count. Acad Emerg Med 2015; 22:856-64. [PMID: 26112797 DOI: 10.1111/acem.12703] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/12/2015] [Accepted: 01/21/2015] [Indexed: 11/28/2022]
Abstract
Shared decision-making (SDM), a collaborative process in which patients and providers make health care decisions together, taking into account the best scientific evidence available, as well as the patient's values and preferences, is being increasingly advocated as the optimal approach to decision-making for many health care decisions. The rapidly paced and often chaotic environment of the emergency department (ED), however, is a unique clinical setting that offers many practical and contextual challenges. Despite these challenges, in a recent survey emergency physicians reported there to be more than one reasonable management option for over 50% of their patients and that they take an SDM approach in 58% of such patients. SDM has also been selected as the topic on which to develop a future research agenda at the 2016 Academic Emergency Medicine consensus conference, "Shared Decision-making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" (http://www.saem.org/annual-meeting/education/2016-aem-consensus-conference). In this paper the authors describe the conceptual model of SDM as originally conceived by Charles and Gafni and highlight aspects of the model relevant to the practice of emergency medicine. In addition, through the use of vignettes from the authors' clinical practices, the applicability of SDM to contemporary EM practice is illustrated and the ethical and pragmatic implications of taking an SDM approach are explored. It is hoped that this document will be read in advance of the 2016 Academic Emergency Medicine consensus conference, to facilitate group discussions at the conference.
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Affiliation(s)
- Erik P. Hess
- The Department of Emergency Medicine; the Knowledge and Evaluation Research Unit; the Division of Healthcare Policy Research; Department of Health Services Research, and the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery; Mayo Clinic; Rochester MN
| | - Corita R. Grudzen
- The Departments of Emergency Medicine and Population Health; New York University; New York NY
| | - Richard Thomson
- The Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - Ali S. Raja
- The Department of Emergency Medicine; Brigham and Women's Hospital; Boston MA
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Resnicow K, Abrahamse P, Tocco RS, Hawley S, Griggs J, Janz N, Fagerlin A, Wilson A, Ward KC, Gabram SGA, Katz S. Development and psychometric properties of a brief measure of subjective decision quality for breast cancer treatment. BMC Med Inform Decis Mak 2014; 14:110. [PMID: 25476986 PMCID: PMC4272518 DOI: 10.1186/s12911-014-0110-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/10/2014] [Indexed: 01/05/2023] Open
Abstract
Background Breast cancer patients face several preference-sensitive treatment decisions. Feelings such as regret or having had inadequate information about these decisions can significantly alter patient perceptions of recovery and recurrence. Numerous objective measures of decision quality (e.g., knowledge assessments, values concordance measures) have been developed; there are far fewer measures of subjective decision quality and little consensus regarding how the construct should be assessed. The current study explores the psychometric properties of a new subjective quality decision measure for breast cancer treatment that could be used for other preference sensitive decisions. Methods 320 women aged 20–79 diagnosed with AJCC stage 0 – III breast cancer were surveyed at two cancer specialty centers. Decision quality was assessed with single items representing six dimensions: regret, satisfaction, and fit as well as perceived adequacy of information, time, and involvement. Women rated decision quality for their overall treatment experience and surgery, chemotherapy, and radiation decisions separately. Principle components was used to explore factor structure. After scales were formed, internal consistency was computed using Cronbach’s alpha. The association of each of the four final scales with patient characteristics scores was examined by Pearson correlation. Results For overall breast cancer treatment as well as surgery, chemotherapy, and radiation decisions, the six items yielded a single factor solution. Factor loadings of the six decision items were all above .45 across the overall and treatment-specific scales, with the exception of “Right for You” for chemotherapy and radiation. Internal consistency was 0.77, 0.85, 0.82, and 0.78 for the overall, surgery, chemotherapy, and radiation decision quality scales, respectively. Conclusions Our measure of subjective appraisal of breast cancer treatment decisions includes 5 related elements; regret and satisfaction as well as perceived adequacy of information, time, and involvement. Future research is needed to establish norms for the measure as is further psychometric testing, particularly to examine how it is associated with outcomes such as quality of life, psychological coping and objective decision quality.
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Affiliation(s)
- Ken Resnicow
- University of Michigan, School of Public Health, 109 Observatory Street, Ann Arbor, MI, 48109-2029, USA.
| | - Paul Abrahamse
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
| | - Rachel S Tocco
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
| | - Sarah Hawley
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. .,Veterans Administration, Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, Building 16, Rm. 421 W, Ann Arbor, MI, 48109-2800, USA.
| | - Jennifer Griggs
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
| | - Nancy Janz
- University of Michigan, School of Public Health, 109 Observatory Street, Ann Arbor, MI, 48109-2029, USA.
| | - Angela Fagerlin
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. .,Veterans Administration, Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, Building 16, Rm. 421 W, Ann Arbor, MI, 48109-2800, USA.
| | - Adrienne Wilson
- University of Michigan, School of Public Health, 109 Observatory Street, Ann Arbor, MI, 48109-2029, USA.
| | - Kevin C Ward
- Emory University, Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
| | - Sheryl G A Gabram
- Department of Surgery, Emory University School of Medicine, Winship Cancer Institute of Emory University, 69 Jesse Hill Jr. Dr. SE, Room 303, Atlanta, GA, 30303, USA.
| | - Steven Katz
- University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
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