Oncologist preferences for health states associated with the treatment of advanced ovarian cancer.
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.
Hess
Lisa M
LM
Indiana University School of Medicine, Departments of Public Health and Obstetrics and Gynecology, Indianapolis, Indiana, USA. lmhess@iupui.edu
Malone
Daniel C
DC
Skrepnek
Grant H
GH
Reed
Pamela G
PG
Armstrong
Edward
E
Coons
Stephen Joel
SJ
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
D000970:Antineoplastic Agents