title: Decision-making process of patients with gynecological cancer regarding their cancer treatment choices using the analytic hierarchy process.
abstract: OBJECTIVE
  In order to support patients' decision-making regarding cancer treatments, it is important to clarify which criteria that cancer patients use to set priorities in their treatment choices. Using the analytic hierarchy process (AHP), a mathematical decision-making method, this article investigates the criteria and the priorities of patients with gynecological cancer.
  
  
  METHODS
  In the AHP, multiple and hierarchical criteria in the decision-making process were organized by a repeated pairwise judgment of the participants so as to serialize the alternatives along with the rational order of the priorities. For the alternatives "to receive treatment" and "to not receive treatment," the following five criteria were set: "anxiety about relapse and metastasis", "distress about side-effects", "advice of family", "advice of medical staff", and "economic burden". The participants determined a pairwise priority scale, as well as a priority scale between the alternatives for every criterion. The logical consistency of their answers was checked by a consistency index (CI). The participants were 31 patients with ovarian or endometrial cancer who were being followed up after undergoing surgery and adjuvant chemotherapy.
  
  
  RESULTS
  Of the participants who answered the questionnaire, 17 satisfied the logical consistency. Of the five criteria for the treatment choices, "anxiety about relapse and metastasis" and "advice of medical staff" were found to be the important factors for treatment choice; however, the weight attached to the priority criteria differed much among the patients.
  
  
  CONCLUSIONS
  The AHP made it possible to support patients' decision-making in order to clarify their priority criteria and to quantitatively present their decision-making process.
authors.affiliation: Cancer Survivorship Research Division, Shizuoka Cancer Center Research Institute, Shizuoka, Japan. y.kitamura@scchr.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitamura
mesh_terms: D003657:Decision Making; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D009362:Neoplasm Metastasis; D012008:Recurrence; D011795:Surveys and Questionnaires