title: Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers.
abstract: BACKGROUND
  Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers.
  
  
  METHODS
  The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years.
  
  
  CONCLUSIONS
  The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes).
  
  
  BACKGROUND
  Clinical Trials Identifier: NCT01485627.
authors.affiliation: Rochester Healthcare Decision-Making Group, University of Rochester Medical Center, Rochester, NY, USA. michael_hoerger@urmc.rochester.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Hoerger
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
authors.forename: Paul C
authors.initials: PC
authors.lastname: Winters
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
authors.forename: Robert
authors.initials: R
authors.lastname: Gramling
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kaesberg
authors.forename: Wan
authors.initials: W
authors.lastname: Tang
authors.forename: Sandy
authors.initials: S
authors.lastname: Plumb
authors.forename: Adam
authors.initials: A
authors.lastname: Walczak
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.forename: Daniel
authors.initials: D
authors.lastname: Tancredi
authors.forename: Alison
authors.initials: A
authors.lastname: Venuti
authors.forename: Camille
authors.initials: C
authors.lastname: Cipri
authors.forename: Gisela
authors.initials: G
authors.lastname: Escalera
authors.forename: Carol
authors.initials: C
authors.lastname: Ferro
authors.forename: Don
authors.initials: D
authors.lastname: Gaudion
authors.forename: Beth
authors.initials: B
authors.lastname: Hoh
authors.forename: Blair
authors.initials: B
authors.lastname: Leatherwood
authors.forename: Linda
authors.initials: L
authors.lastname: Lewis
authors.forename: Mark
authors.initials: M
authors.lastname: Robinson
authors.forename: Peter
authors.initials: P
authors.lastname: Sullivan
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D017028:Caregivers; D003142:Communication; D003657:Decision Making; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D010820:Physicians; D011368:Professional-Family Relations; D011788:Quality of Life; D012107:Research Design; D013727:Terminal Care