Marleen Kunneman1, Arwen H Pieterse2, Anne M Stiggelbout2, Corrie A M Marijnen3. 1. Department of Medical Decision Making, Leiden University Medical Center, The Netherlands. Electronic address: Kunneman@lumc.nl. 2. Department of Medical Decision Making, Leiden University Medical Center, The Netherlands. 3. Department of Clinical Oncology, Leiden University Medical Center, The Netherlands.
Abstract
BACKGROUND AND PURPOSE: We previously found considerable variation in information provision on preoperative radiotherapy (PRT) in rectal cancer. Our aims were to reach consensus among patients and oncologists on which benefits/harms of PRT should be addressed during the consultation, and to assess congruence with daily clinical practice. MATERIALS AND METHODS: A four-round Delphi-study was conducted with two expert panels: (1) 31 treated rectal cancer patients and (2) 35 radiation oncologists. Thirty-seven possible benefits/harms were shown. Participants indicated whether addressing the benefit/harm was (1) essential, (2) desired, (3) not necessary, or (4) to be avoided. Consensus was assumed when ⩾80% of the panel agreed. Results were compared to 81 audio-taped consultations. RESULTS: The panels reached consensus that six topics should be addressed in all patients (local control, survival, long term altered defecation pattern and faecal incontinence, perineal wound healing problems, advice to avoid pregnancy), three in male patients (erectile dysfunction, ejaculation disorder, infertility), and four in female patients (vaginal dryness, pain during intercourse, menopause, infertility). On average, less than half of these topics were addressed in daily clinical practice. CONCLUSIONS: This study showed substantial overlap between benefits/harms that patients and oncologists consider important to address during the consultation, and at the same time poor congruence with daily clinical practice.
BACKGROUND AND PURPOSE: We previously found considerable variation in information provision on preoperative radiotherapy (PRT) in rectal cancer. Our aims were to reach consensus among patients and oncologists on which benefits/harms of PRT should be addressed during the consultation, and to assess congruence with daily clinical practice. MATERIALS AND METHODS: A four-round Delphi-study was conducted with two expert panels: (1) 31 treated rectal cancerpatients and (2) 35 radiation oncologists. Thirty-seven possible benefits/harms were shown. Participants indicated whether addressing the benefit/harm was (1) essential, (2) desired, (3) not necessary, or (4) to be avoided. Consensus was assumed when ⩾80% of the panel agreed. Results were compared to 81 audio-taped consultations. RESULTS: The panels reached consensus that six topics should be addressed in all patients (local control, survival, long term altered defecation pattern and faecal incontinence, perineal wound healing problems, advice to avoid pregnancy), three in male patients (erectile dysfunction, ejaculation disorder, infertility), and four in female patients (vaginal dryness, pain during intercourse, menopause, infertility). On average, less than half of these topics were addressed in daily clinical practice. CONCLUSIONS: This study showed substantial overlap between benefits/harms that patients and oncologists consider important to address during the consultation, and at the same time poor congruence with daily clinical practice.
Authors: Angus G K McNair; Robert N Whistance; Barry Main; Rachael Forsythe; Rhiannon Macefield; Jonathan Rees; Anne Pullyblank; Kerry Avery; Sara Brookes; Michael G Thomas; Paul A Sylvester; Ann Russell; Alfred Oliver; Dion Morton; Robin Kennedy; David Jayne; Richard Huxtable; Roland Hackett; Susan Dutton; Mark G Coleman; Mia Card; Julia Brown; Jane Blazeby Journal: BMJ Open Date: 2019-11-14 Impact factor: 2.692
Authors: Emmanouil Fokas; Ane Appelt; Alexandra Gilbert; David Sebag-Montefiore; Claus Rödel; Robert Glynne-Jones; Geerard Beets; Rodrigo Perez; Julio Garcia-Aguilar; Eric Rullier; J Joshua Smith; Corrie Marijnen; Femke P Peters; Maxine van der Valk; Regina Beets-Tan; Arthur S Myint; Jean-Pierre Gerard; Simon P Bach; Michael Ghadimi; Ralf D Hofheinz; Krzysztof Bujko; Cihan Gani; Karin Haustermans; Bruce D Minsky; Ethan Ludmir; Nicholas P West; Maria A Gambacorta; Vincenzo Valentini; Marc Buyse; Andrew G Renehan Journal: Nat Rev Clin Oncol Date: 2021-08-04 Impact factor: 66.675