PURPOSE: To examine the agreement between prostate cancer patients' utilities for selected health states and their rankings of the importance of six attributes of the health states and the clinicians' judgements of what would be in the patients' best interests. METHOD: Patients with newly diagnosed localized prostate cancer individually completed a time trade-off utility assessment shortly after being diagnosed. The health states evaluated were constructed from a multi-attribute utility model that incorporated six aspects of living with the disease and outcomes of treatment. Each patient assessed his current health state and three hypothetical states that might occur in the future, and provided rankings of the importance of the six attributes. The clinicians caring for each patient independently provided their views of what utilities and importance rankings would be in the patient's best interest. RESULTS: The across-participant correlations between patients' and clinicians' utilities were very low and not statistically significant. Across-participant correlations between patient and clinician importance rankings for the six attributes were also low. Across-health state and across-attribute correlations between utilities or importance rankings were highly variable across patient-clinician pairs. CONCLUSION: In the clinical settings studied, there is not a strong relationship between valuations of current and possible future health states by patients with newly diagnosed prostate cancer and their clinicians. Implications of these results for substituted judgement, when clinicians advise their patients or recommend a treatment strategy, are discussed.
PURPOSE: To examine the agreement between prostate cancerpatients' utilities for selected health states and their rankings of the importance of six attributes of the health states and the clinicians' judgements of what would be in the patients' best interests. METHOD:Patients with newly diagnosed localized prostate cancer individually completed a time trade-off utility assessment shortly after being diagnosed. The health states evaluated were constructed from a multi-attribute utility model that incorporated six aspects of living with the disease and outcomes of treatment. Each patient assessed his current health state and three hypothetical states that might occur in the future, and provided rankings of the importance of the six attributes. The clinicians caring for each patient independently provided their views of what utilities and importance rankings would be in the patient's best interest. RESULTS: The across-participant correlations between patients' and clinicians' utilities were very low and not statistically significant. Across-participant correlations between patient and clinician importance rankings for the six attributes were also low. Across-health state and across-attribute correlations between utilities or importance rankings were highly variable across patient-clinician pairs. CONCLUSION: In the clinical settings studied, there is not a strong relationship between valuations of current and possible future health states by patients with newly diagnosed prostate cancer and their clinicians. Implications of these results for substituted judgement, when clinicians advise their patients or recommend a treatment strategy, are discussed.
Authors: S J Knight; J S Chmiel; L K Sharp; T Kuzel; R B Nadler; R Fine; E M Moran; R Sharifi; C L Bennett Journal: Urology Date: 2001-02 Impact factor: 2.649
Authors: D P Sulmasy; P B Terry; C S Weisman; D J Miller; R Y Stallings; M A Vettese; K B Haller Journal: Ann Intern Med Date: 1998-04-15 Impact factor: 25.391
Authors: Gunnar Steineck; Fred Helgesen; Jan Adolfsson; Paul W Dickman; Jan-Erik Johansson; Bo Johan Norlén; Lars Holmberg Journal: N Engl J Med Date: 2002-09-12 Impact factor: 91.245
Authors: Lindsay Kennedy Brown; Akbar K Waljee; Peter D R Higgins; Jennifer F Waljee; Arden M Morris Journal: Dis Colon Rectum Date: 2011-12 Impact factor: 4.585
Authors: Laura D'Alimonte; Kaitlin Koo; Emily Chen; Deb Feldman-Stewart; Arlene Court; Margaret Fitch; Lisa Di Prospero; John Maamoun; Alex Kiss; Ewa Szumacher Journal: J Cancer Educ Date: 2013-09 Impact factor: 2.037
Authors: James R Broughman; Ramsankar Basak; Matthew E Nielsen; Bryce B Reeve; Deborah S Usinger; Kiayni C Spearman; Paul A Godley; Ronald C Chen Journal: J Natl Cancer Inst Date: 2018-04-01 Impact factor: 13.506
Authors: M T King; R Viney; D P Smith; I Hossain; D Street; E Savage; S Fowler; M P Berry; M Stockler; P Cozzi; P Stricker; J Ward; B K Armstrong Journal: Br J Cancer Date: 2012-01-24 Impact factor: 7.640
Authors: Joaquin Michel; Jorge Ballon; Sarah E Connor; David C Johnson; Jonathan Bergman; Christopher S Saigal; Mark S Litwin; Dana L Alden Journal: MDM Policy Pract Date: 2021-05-27