Pilot Study of Patient and Oncologist Preferences for Chemotherapy Treatment of Advanced Ovarian Cancer

Abstract

Ovarian cancer is the leading cause of gynecologic cancer death among women in the United States, claiming the lives of more than 15,000 women each year. Women who receive this diagnosis must make rapid, critical medical decisions that impact survival and quality of life. Two studies were conducted to obtain pilot data related to the health preferences of ovarian cancer patients and their oncologists. Forty-one eligible patients and 34 eligible physicians participated in this study. Six hypothetical health states were developed based on possible outcomes of ovarian cancer treatment strategies. Participants were asked to rate these health states using a visual analog scale and the standard gamble chance board. A series of exploratory hypotheses were tested to obtain guidance for future research. Patients under surveillance had significantly lower preferences for all health states than patients receiving chemotherapy or physicians. Overall, patients were very consistent across health states with the level of risk they were willing to take, while physicians were significantly more likely to avoid risk when the treatment strategy presented involved improved treatment efficacy, even when associated with higher toxicity and poor emotional well being. These findings show the need for additional research and suggest that research in medical decision making must examine health choices made by patients separately, depending on their current treatment status, but not necessarily by current self-reported health status, time since diagnosis or by recurrent/non-recurrent disease.