title: Accuracy of physician assessment of treatment preferences and health status in elderly patients with higher-risk myelodysplastic syndromes.
abstract: Higher-risk myelodysplastic syndromes (MDS) are rarely curable and have a poor prognosis. We investigated the accuracy of physicians' perception of patients' health status and the patients' preferences for involvement in treatment decisions. We examined 280 newly diagnosed higher-risk elderly MDS patients paired with their physicians. Survey tools included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the Control Preference Scale. Overall concordance was 49% for physician perception of patient preferences for involvement in treatment decisions. In 36.4% of comparisons there were minor differences and in 14.6% there were major differences. In 44.7% of the patients preferring a passive role, physicians perceived them as preferring an active or collaborative role. Absence of the patient's request for prognostic information (P=0.001) and judging the patient as having a poor health status (P=0.036) were factors independently associated with the physicians' attitude toward a lower degree of patient involvement in clinical decisions. Agreement on health status was found in 27.5% of cases. Physicians most frequently tended to overestimate health status of patients who reported low-level health status. The value of decision aid-tools in the challenging setting of higher-risk MDS should be investigated to further promote patient-centered care.
authors.affiliation: Hematology Unit, Department of Internal Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Caocci
authors.affiliation: Department of Hematology, University of Rome "Cattolica S. Cuore", Rome, Italy.
authors.forename: M T
authors.initials: MT
authors.lastname: Voso
authors.affiliation: Department of Hematology, "A. Businco" Hospital, Cagliari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Angelucci
authors.affiliation: Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Stauder
authors.affiliation: Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cottone
authors.affiliation: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: G
authors.initials: G
authors.lastname: Abel
authors.affiliation: Department of Leukemia, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: K
authors.initials: K
authors.lastname: Nguyen
authors.affiliation: Department of Medicine I, University hospital Dresden "Carl Gustav Carus", Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Platzbecker
authors.affiliation: Department of Internal Medicine, CHU Toulouse Purpan, place du Dr Baylac, 31059 Toulouse Cedex, France.
authors.forename: O
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.affiliation: Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gaidano
authors.affiliation: Department of Internal Medicine, University of Pavia-IRCCS, Policlinico San Matteo Foundation, Pavia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Invernizzi
authors.affiliation: Department of Oncology-Hematology, Pugliese-Ciaccio Hospital Center, Catanzaro, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Molica
authors.affiliation: Department of Hematology, University of Rome "Cattolica S. Cuore", Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Criscuolo
authors.affiliation: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Breccia
authors.affiliation: University of Freiburg Medical Center, Freiburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lübbert
authors.affiliation: Department of Hematology and Stem Cell Transplantation Unit, IRCCS 'Casa Sollievo della Sofferenza' Hospital, San Giovanni Rotondo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sanpaolo
authors.affiliation: Department of Hematology, "University of Tor Vergata", Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Buccisano
authors.affiliation: Department of Emergency and Organ Transplantation, Hematology Section, University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ricco
authors.affiliation: UO Ematologia, AOU "Policlinico-V. Emanuele", Catania, Italy.
authors.forename: G A
authors.initials: GA
authors.lastname: Palumbo
authors.affiliation: Department of Hematology, "S. Eugenio Hospital", Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Niscola
authors.affiliation: Department of Hematology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Hematology, S. Giovanni-Addolorata Hospital, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Fenu
authors.affiliation: Hematology Unit, Department of Internal Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: La Nasa
authors.affiliation: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
authors.affiliation: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: F
authors.initials: F
authors.lastname: Efficace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data; D057240:Patient Preference / Q000706:statistics & numerical data; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Cancer; Decision making; Health status; Hematology; Myelodysplastic syndromes; Oncology