title: Clinician perceptions of care difficulty, quality of life, and symptom reports for lung cancer patients: an analysis from the Symptom Outcomes and Practice patterns (SOAPP) study.
abstract: BACKGROUND
  Despite recent therapeutic advances, lung cancer is a difficult disease to manage. This study assessed clinicians' perceptions of care difficulty, quality of life (QOL), and symptom reports for their lung cancer patients compared with their patients with breast, prostate, and colon cancer.
  
  
  METHODS
  This report focused on secondary analyses from the Eastern Cooperative Oncology Group (ECOG) Symptom Outcomes and Practice Patterns (SOAPP) study (E2Z02); outcome measures included clinician ratings of 3106 solid tumor patients. Univariate analyses focused on patterns of disease-specific perceptions; multivariable analyses examined whether disease-specific differences persisted after covariate inclusion.
  
  
  RESULTS
  In univariate comparisons, clinicians rated lung cancer patients as more difficult to treat than other solid tumor patients, with poorer QOL and higher symptom reports. After covariates were adjusted, the odds of clinicians perceiving lower QOL for their lung cancer patients were 3.6 times larger than for patients with other solid tumors (odds ratio = 3.6 [95% confidence interval, 2.0-6.6]; p < 0.0001). In addition, the odds of clinicians perceiving weight difficulties for their lung cancer patients were 3.2 times larger (odds ratio = 3.2 [95% confidence interval, 1.7-6.0]; p = 0.0004). No other outcome showed significant differences between lung versus other cancers in multivariable models.
  
  
  CONCLUSIONS
  Clinicians were more pessimistic about the well-being of their lung cancer patients compared with patients with other solid tumors. Differences remained for clinician perceptions of patient QOL and weight difficulty, even after controlling for such variables as stage, performance status, and patient-reported outcomes. These continuing disparities suggest possible perception bias. More research is needed to confirm this disparity and explore the underpinnings.
authors.affiliation: *Harold C. Simmons Cancer Center, Departments of Psychiatry and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas; †Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, Massachusetts; ‡Harold C. Simmons Cancer Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; §Department of Medical Oncology, Vanderbilt University, Nashville, Tennessee; ‖Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ¶VA New Jersey Health Care System, East Orange, New Jersey, Rutgers - New Jersey Medical School, Newark, New Jersey; and #Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Hamann
authors.forename: Ju-Whei
authors.initials: JW
authors.lastname: Lee
authors.forename: Joan H
authors.initials: JH
authors.lastname: Schiller
authors.forename: Leora
authors.initials: L
authors.lastname: Horn
authors.forename: Lynne I
authors.initials: LI
authors.lastname: Wagner
authors.forename: Victor Tsu-Shih
authors.initials: VT
authors.lastname: Chang
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017063:Outcome Assessment, Health Care; D005791:Patient Care; D010465:Perception; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult