title: Desire for information and involvement in treatment decisions: lung cancer patients' preferences and their physicians' perceptions: results from Okayama Lung Cancer Study Group Trial 0705.
abstract: BACKGROUND
  This study explores patient preferences for involvement in lung cancer treatment decisions and the extent of concordance between the views of patients and physicians on decisional roles. The impact of demographic and psychosocial characteristics on the decisional role of patients is also examined.
  
  
  METHODS
  Patients with relapsed non-small cell lung cancer who were candidates for a phase II trial of erlotinib monotherapy were recruited. Patients were interviewed after they had learned of their relapse and the treatment decision had been made but before pharmacologic intervention.
  
  
  RESULTS
  Most of the 28 participants were married, had a smoking history, and were well educated. They reported moderate levels of depression and anxiety. Initially, 14% of the patients reported a preference for active decision making; later, 29% believed that the primary responsibility for the treatment decision had been theirs. Only 54% of the patients agreed with the physician's assessment of how the treatment decision was made (κ = 0.31; test of symmetry, p = 0.23). The depression score was significantly associated with a patient's preferred level of control (p < 0.01).
  
  
  CONCLUSIONS
  The limited concordance between patient preference and perception and between patient and physician perceptions regarding how the treatment decision was made suggests that physicians should more accurately identify patient preferences by directly asking patients at the beginning of each clinical encounter.
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, Kitaku, Okayama, Japan. khotta@md.okayama-u.ac.jp
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hotta
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Fukuyama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Toshihide
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kuyama
authors.forename: Shigeki
authors.initials: S
authors.lastname: Umemura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kato
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Nogami
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Segawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yasugi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tabata
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D000230:Adenocarcinoma / Q000523:psychology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017322:Clinical Trials, Phase II as Topic; D003657:Decision Making; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies