Discussing molecular testing in oncology care: Comparing patient and physician information preferences

• Type of Material: Article
• Authors: Ana P. M. Pinheiro, Emory University; Rachel H. Pocock, Emory University; Jeffrey M. Switchenko, Emory University; Margie Dixon, Emory University; Walid Shaib, Emory University; Suresh S Ramalingam, Emory University; Rebecca Pentz, Emory University
• Language: English
• Date: 2017-05-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Cancer Society
• Final Published Version (URL): http://dx.doi.org/10.1002/cncr.30494
• Title of Journal or Parent Work: Cancer
• ISSN: 0008-543X
• Volume: 123
• Issue: 9
• Start Page: 1610
• End Page: 1616
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI(P30CA138292).
• Keywords: patient preference; communication; COMMUNICATING PROGNOSIS; INFORMED-CONSENT; INCIDENTAL FINDINGS; Science & Technology; BAD-NEWS; Life Sciences & Biomedicine; PATIENTS PERSPECTIVE; GENOMIC MEDICINE; DECISION-MAKING; informed consent; Oncology; AMERICAN SOCIETY; NEXT-GENERATION; CANCER CLINICAL-TRIALS; molecular testing
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology

Abstract

BACKGROUND: Molecular testing to inform treatment and clinical trial choices is now the standard of care for several types of cancer. However, no established guidelines exist for the type of information physicians should cover during discussions with the patient about the test or its results. The objectives of this study were to identify physician and patient preferences regarding information and who should communicate this information and how to inform guidelines for these conversations. METHODS: Physicians and patients who participated in discussions regarding molecular testing were asked to choose 8 topics of most relevance out of a list of 18. The McNemar test was used to determine their top preferences. Patients were asked to identify what information they wanted to receive and who should inform them, and physicians were asked to identify the best aid to communication. RESULTS: Sixty-six patients identified 12 preferred topics: the benefits of testing (88%), how testing determines treatment (88%), implications for family (71%), whether a test indicates the seriousness of disease (68%), purpose of the test (64%), incidental findings (56%), explanation of cancer genetics (53%), how the test is done (46%), limitations (44%), explanation of biomarker (42%), risks (42%), and uninformative results (38%). Physicians added cost (59%). Patients preferred receiving information about molecular testing from their nurse or physician (85%), and physicians preferred using a pamphlet (67%) to augment communication. CONCLUSIONS: The topics identified as important to discuss can inform future guidelines and can contribute to effective communication regarding molecular testing.