Dana Ruetters1, Christian Keinki1, Sarah Schroth1, Patrick Liebl1, Jutta Huebner2. 1. German Cancer Society, Berlin, Germany. 2. Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. huebner@med.uni-frankfurt.de.
Abstract
BACKGROUND: With growing complexity of diagnostics and therapy, as well as increasing involvement of patients in the decision-making process, there is more and more demand for second opinions in oncology. This literature review aims at analyzing the benefits and risks involved, as well as the tools needed to establish a structured program for second opinion within a modern healthcare system. METHODS: A systematic literature search was performed using MEDLINE and Embase and the databases SocINDEX, ERIC and CINAHL. Thirteen articles met the inclusion criteria and offered a relevant insight into the topic of second opinions. RESULTS: Depending on the study, between 6.5 and 36 % of patients search for a second opinion, due to a variety of reasons. Changes in diagnosis, treatment recommendations or prognosis as a result of the second opinion occurred in 12-69 % of cases. In 43-82 % of cases, the original diagnosis or treatment was verified. Patient satisfaction was high, and the second opinion was deemed as helpful and reassuring in most cases. Yet, data on patient-relevant outcomes or on the quality of the second opinion are missing. CONCLUSION: In general, outcome data on second opinion are divergent and scarce. Yet, with patients' demand for second opinion and influence of second opinion on treatment decisions, a structured, high quality and transparent second-opinion program seems mandatory. Such a program may support patient-physician communication and improve the flow of information, as well as decision-making. Its evaluation should be independent from the provider of the second opinion.
BACKGROUND: With growing complexity of diagnostics and therapy, as well as increasing involvement of patients in the decision-making process, there is more and more demand for second opinions in oncology. This literature review aims at analyzing the benefits and risks involved, as well as the tools needed to establish a structured program for second opinion within a modern healthcare system. METHODS: A systematic literature search was performed using MEDLINE and Embase and the databases SocINDEX, ERIC and CINAHL. Thirteen articles met the inclusion criteria and offered a relevant insight into the topic of second opinions. RESULTS: Depending on the study, between 6.5 and 36 % of patients search for a second opinion, due to a variety of reasons. Changes in diagnosis, treatment recommendations or prognosis as a result of the second opinion occurred in 12-69 % of cases. In 43-82 % of cases, the original diagnosis or treatment was verified. Patient satisfaction was high, and the second opinion was deemed as helpful and reassuring in most cases. Yet, data on patient-relevant outcomes or on the quality of the second opinion are missing. CONCLUSION: In general, outcome data on second opinion are divergent and scarce. Yet, with patients' demand for second opinion and influence of second opinion on treatment decisions, a structured, high quality and transparent second-opinion program seems mandatory. Such a program may support patient-physician communication and improve the flow of information, as well as decision-making. Its evaluation should be independent from the provider of the second opinion.
Entities:
Keywords:
Cancer; Counseling; Information; Patients’ needs; Second opinion
Authors: C Keinki; E Seilacher; M Ebel; D Ruetters; I Kessler; J Stellamanns; I Rudolph; J Huebner Journal: J Cancer Educ Date: 2016-09 Impact factor: 2.037
Authors: Velma L Payne; Hardeep Singh; Ashley N D Meyer; Lewis Levy; David Harrison; Mark L Graber Journal: Mayo Clin Proc Date: 2014-05 Impact factor: 7.616
Authors: Scott D Ramsey; Steven B Zeliadt; Catherine R Fedorenko; David K Blough; Carol M Moinpour; Ingrid J Hall; Judith Lee Smith; Donatus U Ekwueme; Megan E Fairweather; Ian M Thompson; Thomas E Keane; David F Penson Journal: World J Urol Date: 2010-10-20 Impact factor: 4.226
Authors: W A M Mellink; A M V Dulmen; Th Wiggers; P M M Spreeuwenberg; A M M Eggermont; J M Bensing Journal: J Clin Oncol Date: 2003-04-15 Impact factor: 44.544
Authors: Friedemann Zengerling; Michael Hartmann; Axel Heidenreich; Susanne Krege; Peter Albers; Alexander Karl; Lothar Weissbach; Walter Wagner; Jens Bedke; Margitta Retz; Hans U Schmelz; Sabine Kliesch; Markus Kuczyk; Eva Winter; Tobias Pottek; Klaus-Peter Dieckmann; Andres Jan Schrader; Mark Schrader Journal: Oncol Rep Date: 2014-04-24 Impact factor: 3.906
Authors: Liora Shmueli; Erez Shmueli; Joseph S Pliskin; Ran D Balicer; Nadav Davidovitch; Igal Hekselman; Geva Greenfield Journal: BMJ Open Date: 2019-07-27 Impact factor: 2.692
Authors: Christian R Loehberg; Julia Meyer; Lothar Häberle; Carolin C Hack; Sebastian Jud; Alexander Hein; Marius Wunderle; Julius Emons; Paul Gass; Peter A Fasching; Sainab Egloffstein; Jessica Krebs; Yesim Erim; Matthias W Beckmann; Michael P Lux; Sonja Wasner Journal: Arch Gynecol Obstet Date: 2020-04-09 Impact factor: 2.344
Authors: N C A van der Velden; M B A van der Kleij; V Lehmann; E M A Smets; J M L Stouthard; I Henselmans; M A Hillen Journal: Int J Environ Res Public Health Date: 2021-05-26 Impact factor: 3.390