David E Cohn1, Laura J Havrilesky2, Kathryn Osann3, Joseph Lipscomb4, Susie Hsieh3, Joan L Walker5, Alexi A Wright6, Ronald D Alvarez7, Beth Y Karlan8, Robert E Bristow3, Paul A DiSilvestro9, Mark T Wakabayashi10, Robert Morgan10, Dana B Mukamel11, Lari Wenzel3. 1. The Ohio State University, Columbus, OH, United States. Electronic address: david.cohn@osumc.edu. 2. Duke University School of Medicine, Durham, NC, United States. 3. University of California at Irvine, Irvine, CA, United States. 4. Emory University Rollins School of Public Health and Winship Cancer Institute, Atlanta, GA, United States. 5. The University of Oklahoma, Oklahoma City, OK, United States. 6. Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA, United States. 7. University of Alabama at Birmingham, Birmingham, AL, United States. 8. Cedars Sinai Medical Center, Los Angeles, CA, United States. 9. Women & Infants Hospital, Brown University, Providence, RI, United States. 10. City of Hope, Duarte, CA, United States. 11. University of California Irvine, School of Medicine, Orange, CA, United States.
Abstract
OBJECTIVES: To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. METHODS: A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. RESULTS: The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). CONCLUSIONS: Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.
OBJECTIVES: To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. METHODS: A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. RESULTS: The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). CONCLUSIONS: Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.
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