Patient Perceptions of Treatment Benefit and Toxicity in Advanced Cancer: A Prospective Cross-Sectional Study

2021 ◽  
Vol 17 (2) ◽  
pp. e119-e129
Author(s):  
Rushad Patell ◽  
David Einstein ◽  
Eric Miller ◽  
Laura Dodge ◽  
Jennifer Halleck ◽  
...  
Keyword(s):  
Survival Benefit ◽  
Tumor Response ◽  
Cross Sectional Study ◽  
Patient Perceptions ◽  
Cancer Therapies ◽  
The Novel ◽  
Treatment Benefit ◽  
Cross Sectional ◽  
Treatment Benefits ◽  
Symptom Palliation

PURPOSE: Prior studies show that many patients receiving palliative cancer therapies misperceive likelihood of cure. Patients’ understanding of treatment benefits and risks beyond cure is unknown. We explore patient perceptions of palliative treatment in the novel therapeutic era. METHODS: We surveyed patients with advanced solid cancers and their oncologists regarding benefits and risks of palliative therapies. We assessed perceived likelihood of tumor response, survival benefit, symptom palliation, and side effects. We used generalized estimating equations to calculate least squares means of misperception (patient-assessed minus physician-assessed likelihood of benefit), accounting for clustering by physician, and compared the degree of misperception by participant characteristics. RESULTS: Of the 119 patients enrolled, median age was 65 years (range, 59-73 years), 55% were male, and 56% had prior treatment. Treatments included chemotherapy (60%), immunotherapy (24%), and targeted therapy (15%). Compared with their oncologists, patients overestimate curability (median misperception, 20%; interquartile range [IQR], 0 to 60), chances of tumor response (median, 20%; IQR, 0 to 40), symptom palliation (median, 10%; IQR, −10 to 30), and survival benefit (median, 20%; IQR, 0 to 40). Toxicity was relatively accurately estimated (median, 0.5%; IQR, −20 to 20). Immunotherapy was associated with higher risk of misperception of tumor response and toxicity. Misperceptions of tumor response and curability did not correlate (r = 0.13, P = .15). CONCLUSION: Compared with their oncologists, patients overestimated chances of tumor response, symptom palliation, and survival benefit, but accurately perceived likelihood of toxicity. There was no strong correlation between perception of curability and other goals of therapy. Communication focused on treatment goals alongside risks may reduce misperceptions and facilitate informed choices by patients.

Patient perceptions of treatment benefit in advanced cancer.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 25-25
Author(s):  
Rushad Patell ◽  
David Johnson Einstein ◽  
Jennifer Halleck ◽  
Laura Dodge ◽  
Mary K. Buss
Keyword(s):  
Targeted Therapy ◽  
Information Seeking ◽  
Survival Benefit ◽  
Tumor Response ◽  
Patient Perceptions ◽  
Cancer Therapies ◽  
Treatment Benefit ◽  
Treatment Benefits ◽  
Seeking Behavior ◽  
Symptom Palliation

25 Background: Informed consent assumes accurate perceptions of potential treatment benefits and risks, yet many patients receiving palliative cancer therapies misperceive the likelihood of cure. Patients’ understanding of treatment benefits/risks beyond cure is unknown. We aimed to further explore patient perceptions of benefits/risks of palliative treatment in the era of novel therapeutics. Methods: We surveyed patients with advanced solid cancers and their oncologists regarding benefits/risks of palliative therapies. We assessed perceived likelihood of tumor response, survival benefit, symptom palliation and side effects, as well as information-seeking behavior. We used log binomial regression to estimate risk ratios (RR) and 95% confidence intervals (CI) of the association between misperception (patient perception minus physician’s perception) and various demographic, disease and treatment characteristics. Results: Of 119 patients enrolled: median age was 65 years (range 59–73), 55% male and 56% had prior treatment. Treatments included chemotherapy (60%), immunotherapy (25%) and targeted therapy (16%). Median misperceptions are shown in Table. Factors associated with decreased misperception included male gender (RR=0.70, 95% CI: 0.55–0.89), graduate level education (RR=0.63, 95% CI: 0.41–0.98) and targeted therapy (RR=0.54, 95% CI: 0.30–0.98). There was no correlation between misperceptions of tumor response and curability (r=0.13, P=0.15) or self-education (r=-0.04, P=0.69). Conclusions: Compared with their oncologists, patients’ overestimate not only curability but also chances of tumor response, symptom palliation and survival benefit; though they accurately perceive likelihood of toxicity. There is no correlation between perception of curability and other goals of therapy such as response rate and symptom palliation. Improvements in communication should focus on the likelihood of different treatment goals rather than treatment risks. [Table: see text]

Patient perceptions of treatment benefit in advanced cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23163-e23163 ◽  
Author(s):  
Rushad Patell ◽  
David Johnson Einstein ◽  
Jennifer Halleck ◽  
Mary K. Buss
Keyword(s):  
Information Seeking ◽  
Survival Benefit ◽  
Tumor Response ◽  
Patient Perceptions ◽  
Information Seeking Behavior ◽  
Treatment Benefit ◽  
End Of Treatment ◽  
Seeking Behavior ◽  
Symptom Palliation ◽  
Decisional Regret

e23163 Background: Informed consent assumes accurate perceptions of potential benefits and risks of treatment, yet many patients receiving palliative cancer therapies misperceive the likelihood of cure. Our study aims to further explore patient perceptions of benefits and risks of palliative treatments and to examine this in the era of novel therapeutics. Methods: We surveyed patients with advanced solid cancers and their oncologists regarding benefits/risks of palliative therapies. We serially assessed patients’ perceptions of likelihood of tumor response, survival benefit, symptom palliation and side effects, as well as information-seeking behavior pre-treatment and decisional regret at the end of treatment. We also compared patients’ perceptions of benefits/risks to that of their oncologists. Results: Across four disease groups, 52 patients have enrolled (target accrual: 120). Median age is 64 years (range 20-84), 58% are male, and 60% had prior treatment. Treatments included chemotherapy (42%), targeted therapy (31%), and immunotherapy (27%). Misperceptions (patient-assessed likelihood minus oncologist-assessed likelihood) at the beginning of treatment across different domains are shown in the table. Conclusions: Compared with their oncologists, patients overestimate not only curability but also chance of tumor response, symptom palliation, and survival benefit, yet they accurately perceive chance of toxicity. Thus, efforts at improving communication should focus on the chances of treatment benefit and multiple types of benefits rather than treatment risks. In future analyses after full accrual, we will assess differences between domains, internal consistency of misperceptions, change in misperceptions over time on treatment, decisional regret at end of treatment, and association of misperceptions with information-seeking behavior and sources of education. [Table: see text]

scholarly journals Influenza Vaccination in Psoriatic Patients—Epidemiology and Patient Perceptions: A German Multicenter Study (Vac-Pso)

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 843
Author(s):  
Christian Kromer ◽  
Phoebe Wellmann ◽  
Ralf Siemer ◽  
Selina Klein ◽  
Johannes Mohr ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Inflammatory Diseases ◽  
Influenza Virus Infection ◽  
Multivariate Regression Analysis ◽  
Cross Sectional Study ◽  
Patient Perceptions ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Disease Characteristics ◽  
History Of

The risk of developing severe complications from an influenza virus infection is increased in patients with chronic inflammatory diseases such as psoriasis (PsO) and atopic dermatitis (AD). However, low influenza vaccination rates have been reported. The aim of this study was to determine vaccination rates in PsO compared to AD patients and explore patient perceptions of vaccination. A multicenter cross-sectional study was performed in 327 and 98 adult patients with PsO and AD, respectively. Data on vaccination, patient and disease characteristics, comorbidity, and patient perceptions was collected with a questionnaire. Medical records and vaccination certificates were reviewed. A total of 49.8% of PsO and 32.7% of AD patients were vaccinated at some point, while in season 2018/2019, 30.9% and 13.3% received an influenza vaccination, respectively. There were 96.6% and 77.6% of PsO and AD patients who had an indication for influenza vaccination due to age, immunosuppressive therapy, comorbidity, occupation, and/or pregnancy. Multivariate regression analysis revealed higher age (p < 0.001) and a history of bronchitis (p = 0.023) as significant predictors of influenza vaccination in PsO patients. Considering that most patients had an indication for influenza vaccination, the rate of vaccinated patients was inadequately low.

Sick on the Frontlines:A Cross Sectional Study on COVID-19 Infection, Symptom Severity Amongst Emergency Medicine Residents and Fellows in Urban Academic Hospital Settings (Preprint)

2021 ◽  
Author(s):  
Stacey Frisch ◽  
Sarah Jones ◽  
James Willis ◽  
Richard Sinert
Keyword(s):  
New York ◽  
Emergency Medicine ◽  
Cross Sectional Study ◽  
The Novel ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Time Period ◽  
High Infection ◽  
Novel Coronavirus ◽  
Specific Symptoms

BACKGROUND COVID-19, an illness caused by the novel coronavirus SARS-CoV-2, affected many aspects of healthcare worldwide in 2020. From March to May of 2020, New York City (NYC) experienced a large surge of cases. OBJECTIVE The authors aimed to characterize the amount of illness experienced by residents and fellows in 2 NYC hospitals during this time period. METHODS This was a cross-sectional observational study. An IRB-exempt survey was distributed to emergency medicine housestaff in May 2020 and submissions were accepted through August 2020. RESULTS 64 residents and fellows responded to our survey (a 62% response rate). 42% of responders tested positive for SARS-CoV-2 antibodies. Most residents experienced symptoms that could be consistent with COVID-19 however few received PCR testing. Fevers and/or chills along with loss of smell and/or taste were the most specific symptoms for COVID-19, with p-values <0.05. All 13 housestaff who reported no symptoms during the study period tested negative for SARS-CoV-2 antibodies. CONCLUSIONS Our study demonstrated that the rate of COVID-19 illness among emergency department housestaff is much higher than previously reported. Further studies are needed to characterize illness among medical staff in emergency departments across the nation. The high infection rate among emergency medicine trainees stresses the importance of supplying adequate PPE for healthcare professionals.

scholarly journals Prevalence and correlates of forgone care among adult Israeli Jews: A survey conducted during the COVID-19 outbreak

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260399
Author(s):  
Perla Werner ◽  
Aviad Tur-Sinai
Keyword(s):  
Behavioral Model ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
The Novel ◽  
Cross Sectional ◽  
Social Distancing ◽  
The Public ◽  
The Social ◽  
Seeking Help ◽  
Novel Coronavirus

Efforts to control the spread of the novel Coronavirus (COVID-19) pandemic include drastic measures such as isolation, social distancing, and lockdown. These restrictions are accompanied by serious adverse consequences such as forgoing of healthcare. The study aimed to assess the prevalence and correlates of forgone care for a variety of healthcare services during a two-month COVID-19 lockdown, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using computerized phone interviews was conducted with 302 Israeli Jewish participants aged 40 and above. Almost half of the participants (49%) reported a delay in seeking help for at least one needed healthcare service during the COVID-19 lockdown period. Among the predisposing factors, we found that participants aged 60+, being more religious, and reporting higher levels of COVID-19 fear were more likely to report forgone care than younger, less religious and less concerned participants. Among need factors, a statistically significant association was found with a reported diagnosis of diabetes, with participants with the disease having a considerably higher likelihood of forgone care. The findings stress the importance of developing interventions aimed at mitigating the phenomenon of forgoing care while creating nonconventional ways of consuming healthcare services. In the short term, healthcare services need to adapt to the social distancing and isolation measures required to stanch the epidemic. In the long term, policymakers should consider alternative ways of delivering healthcare services to the public regularly and during crisis without losing sight of their budgetary consequences. They must recognize the possibility of having to align medical staff to the changing demand for healthcare services under conditions of health uncertainty.

scholarly journals Are online searches for the novel coronavirus (COVID-19) related to media or epidemiology? A cross-sectional study

2020 ◽  
Vol 97 ◽  
pp. 386-390 ◽  
Author(s):  
Tomasz Szmuda ◽  
Shan Ali ◽  
Tarjei Vevang Hetzger ◽  
Philip Rosvall ◽  
Paweł Słoniewski
Keyword(s):  
Cross Sectional Study ◽  
The Novel ◽  
Sectional Study ◽  
Cross Sectional ◽  
Online Searches ◽  
Novel Coronavirus

scholarly journals Changes in Mental Health of Women Undergoing Assisted Reproductive Technology Treatment During the COVID-19 Pandemic Outbreak in Xi'an, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Pengfei Qu ◽  
Doudou Zhao ◽  
Peng Jia ◽  
Shaonong Dang ◽  
Wenhao Shi ◽  
...  
Keyword(s):  
Mental Health ◽  
Assisted Reproductive Technology ◽  
Control Period ◽  
Cross Sectional Study ◽  
Reproductive Technology ◽  
The Novel ◽  
Cross Sectional ◽  
Outbreak Period ◽  
Global Pandemic ◽  
Novel Coronavirus

Objective: To investigate the mental health of women undergoing assisted reproductive technology (ART) treatment during the novel coronavirus pneumonia (COVID-19) pandemic outbreak in Xi'an, China.Methods: A repeated cross-sectional study was administered to women undergoing ART treatment during the outbreak period (599 women in February 2020) and the control period (892 women in May 2020) at the Northwest Women's and Children's Hospital, Xi'an, China.Results: Both the ART-treated women surveyed during the outbreak period and those surveyed during the control period had high scores on the fear dimension (0.88, 0.51). The total scores for mental health among the participants during the control period were lower than those during the outbreak period (difference = −0.22; 95% CI = −0.25, −0.18). Lower scores were also seen during the control period, compared to those in the outbreak period, for depression (difference = −0.18; 95% CI = −0.23, −0.13), neurasthenia (difference = −0.31; 95% CI = −0.36, −0.25), fear (difference = −0.37; 95% CI = −0.43, −0.31), compulsion anxiety (difference = −0.13; 95% CI = −0.16, −0.09), and hypochondriasis (difference = −0.09; 95% CI = −0.12, −0.06).Conclusions: During the COVID-19 global pandemic, the mental health of women undergoing ART treatment in Xi'an, China, was primarily manifested as fear. As the pandemic was brought under control, the mental health of ART-treated women improved. As evidenced by these results, the COVID-19 pandemic influences the mental health of women undergoing ART treatment, and clinicians should be aware of this for similar future situations.

scholarly journals Fear of COVID-19 and Trust in the Healthcare System Mediates the Association between Individual’s Risk Perception and Preventive COVID-19 Behaviours among Iranians

2021 ◽  
Vol 18 (22) ◽  
pp. 12146
Author(s):  
Mehran Alijanzadeh ◽  
Daniel Kwasi Ahorsu ◽  
Zainab Alimoradi ◽  
Narges Mahmoudi ◽  
Mark D. Griffiths ◽  
...  
Keyword(s):  
Risk Perception ◽  
Healthcare System ◽  
Sampling Method ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
The Novel ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Novel Coronavirus

Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual’s risk perception and performing preventive COVID-19 behaviours among Iranians. A cross-sectional study design was used to collect data from 3652 residents of Qazvin province in Iran from 3 February to 15 April 2021 using a multistage stratified cluster sampling method. Participants responded to an online questionnaire concerning their fear of COVID-19, risk perception, trust in the healthcare system, and preventive COVID-19 behaviours. Small to medium positive interrelationships were observed between the variables of the study. Fear of COVID-19, trust in the healthcare system or both (fear of COVID-19 and trust in the healthcare system) mediated the association between an individual’s risk perception and performing preventive COVID-19 behaviours. The study demonstrated there are at least four ways through which an individual’s risk perception can influence preventive COVID-19 behaviours. Therefore, clinicians, health communicators, and researchers may capitalize on these findings to enhance preventive COVID-19 behaviours to help mitigate the spread of COVID-19 infection.

scholarly journals COVID-19 quarantine: Post-traumatic stress symptomatology among Lebanese citizens

2020 ◽  
Vol 66 (7) ◽  
pp. 666-674 ◽  
Author(s):  
Mirna Fawaz ◽  
Ali Samaha
Keyword(s):  
Traumatic Stress ◽  
Cross Sectional Study ◽  
The Novel ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Epidemic Curve ◽  
Global Spread ◽  
Post Traumatic ◽  
The Times ◽  
Novel Coronavirus

Background: In the light of the global spread of the novel Coronavirus known as COVID-19 and in the absence of an approved treatment and vaccination, Lebanon has taken national measures, among which was home quarantine of the general public in an attempt to flatten the epidemic curve and avoid flooding the health care system. Aim: This study aimed at evaluating the prevalence of post-traumatic stress symptomatology (PTSS) during the times of COVID-19 quarantine among Lebanese citizens. Method: This quantitative cross-sectional study recruited 950 civilians and is aimed at measuring the prevalence of PTSS among the Lebanese citizens at an interval of 2 weeks and 1 month of COVID-19 quarantine. Results: The results have shown that quarantine in Lebanon has started to give rise to Post-traumatic Stress Disorder symptomatology during the second week which was worsened in the fourth week of COVID-19 quarantine. Conclusion: COVID-19 quarantine has influenced the psychology of Lebanese citizens and might have persistent effects after the end of this phase which is recommended to be explored.

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