title: Oncologist preferences for health states associated with the treatment of advanced ovarian cancer.
abstract: BACKGROUND
  For advanced epithelial ovarian cancer, oncologists are faced with multiple treatment options that differ in terms of possible clinical and patient-reported outcomes.
  
  
  OBJECTIVE
  To explore oncologists' preferences for hypothetical outcome scenarios (i.e. health states) resulting from various treatment options.
  
  
  METHODS
  Six hypothetical health states reflecting varying levels of toxicity, treatment efficacy and emotional well-being were developed representing advanced ovarian cancer treatment. During face-to-face interviews, oncologists provided their relative preferences for these health states using a visual analogue scale and Standard Gamble exercise.
  
  
  RESULTS
  The 34 participating oncologists consistently preferred health states reflecting high treatment efficacy over low efficacy for patients with newly diagnosed disease, regardless of toxicity or emotional well-being. In the setting of recurrent disease, physicians preferred a heath state only if it reflected both high efficacy and positive emotional well-being.
  
  
  CONCLUSIONS
  These data suggest that oncologists may choose treatments that maximize clinical efficacy only when not associated with severe toxicities or low emotional well-being unless associated with a large improvement in efficacy. Physicians may prefer a more toxic chemotherapy regimen that improves survival, and are more willing to compromise emotional well-being for a large survival advantage in the setting of newly diagnosed disease. Slight improvements in clinical efficacy may not be acceptable to oncologists unless associated with higher emotional well-being for the patient.
authors.affiliation: Indiana University School of Medicine, Departments of Public Health and Obstetrics and Gynecology, Indianapolis, Indiana, USA. lmhess@iupui.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Hess
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Malone
authors.forename: Grant H
authors.initials: GH
authors.lastname: Skrepnek
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Reed
authors.forename: Edward
authors.initials: E
authors.lastname: Armstrong
authors.forename: Stephen Joel
authors.initials: SJ
authors.lastname: Coons
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005716:Game Theory; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008495:Medical Oncology; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment
chemical_list: D000970:Antineoplastic Agents