title: Patient-doctor agreement on recall of clinical trial discussion across cultures.
abstract: BACKGROUND
  The purpose was to investigate patient-doctor agreement on clinical trial discussion cross-culturally.
  
  
  METHODS
  In the International Breast Cancer Study Group Trial 33-03 on shared decision-making for early breast cancer in Australian/New Zealand (ANZ) and Swiss/German/Austrian (SGA) centers, doctor and patient characteristics plus doctor stress and burnout were assessed. Within 2 weeks post-consultation about treatment options, the doctor and patient reported independently, whether a trial was discussed. Odds ratios of agreement for covariables were estimated by generalized estimating equations for each language cohort, with doctor as a random effect.
  
  
  RESULTS
  In ANZ, 21 doctors and 339 patients were eligible; in SGA, 41 doctors and 427 patients. In cases where the doctor indicated 'no trial discussed', 82% of both ANZ and SGA patients agreed; if the doctor indicated 'trial discussed', 50% of ANZ and 38% of SGA patients agreed, respectively. Factors associated with higher agreement were: low tumor grade and fewer patients recruited into clinical trials in SGA; public institution, patient born in ANZ (versus other), higher doctor depersonalization and personal accomplishment in ANZ.
  
  
  CONCLUSIONS
  There is discordance between oncologists and their patients regarding clinical trial discussion, particularly when the doctor indicates that a trial was discussed. Factors contributing to this agreement vary by culture.
authors.affiliation: IBCSG Coordinating Center, Bern; Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland. Electronic address: juerg.bernhard@ibcsg.org.
authors.forename: J
authors.initials: J
authors.lastname: Bernhard
authors.affiliation: IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA.
authors.forename: J
authors.initials: J
authors.lastname: Aldridge
authors.affiliation: School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED); Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.
authors.forename: P N
authors.initials: PN
authors.lastname: Butow
authors.affiliation: IBCSG Coordinating Center, Bern.
authors.forename: P
authors.initials: P
authors.lastname: Zoller
authors.affiliation: Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, USA.
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.affiliation: School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED).
authors.forename: I
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D002986:Clinical Trials as Topic; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011939:Mental Recall; D010817:Physician-Patient Relations; D013315:Stress, Psychological