ArticleThe oncologist2013
"Well, I think there is great variation...": a qualitative study of oncologists' experiences and views regarding medical criteria and other factors relevant to treatment decisions in advanced cancer.
Article in The oncologist, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Healthcare Professionals' Perceptions of Decision-Making for Older Patients with Cancer Receiving Systemic Therapy: A Systematic Review and Qualitative Evidence Synthesis.Annals of geriatric medicine and research · 2026Pooled it
- Psychological Determinants of Physician Variation in End-of-Life Treatment Intensity: A Systematic Review and Meta-Synthesis.Journal of general internal medicine · 2023Pooled it
- Withdrawal of anticancer therapy in advanced disease: a systematic literature review.BMC cancer · 2015Pooled it
- Extraction of Treatments and Responses From Non-Small Cell Lung Cancer Clinical Notes Using Natural Language Processing.JCO clinical cancer informatics · 2026Article
- Hospital variation in treatment for synchronous metastatic esophageal and gastric cancer: A nationwide population-based study in the Netherlands.International journal of cancer · 2025Article
- The communication experiences of persons referred to specialist palliative care services and their carers: A descriptive phenomenological study.Palliative & supportive care · 2025Article
- Patients' psychosocial attributes and aggressiveness of cancer treatments near the end of life.The oncologist · 2025Article
- Tough Clinical Decisions: Experiences of Polish Physicians.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2024Article
- Perceptions of Fertility Physicians Treating Women Undergoing IVF Using an Egg Donation.International journal of environmental research and public health · 2022Article
- Article
- Beliefs held by breast surgeons that impact the treatment decision process for advanced breast cancer patients: a qualitative study.Breast cancer (Dove Medical Press) · 2019Article
- Chemotherapy Use at the End of Life in Uganda.Journal of global oncology · 2017Article
- Limiting treatment and shortening of life: data from a cross-sectional survey in Germany on frequencies, determinants and patients' involvement.BMC palliative care · 2017Article
- Article
- Volume matters in the systemic treatment of metastatic pancreatic cancer: a population-based study in the Netherlands.Journal of cancer research and clinical oncology · 2016Article
- Multicriteria decision analysis in oncology.Health expectations : an international journal of public participation in health care and health policy · 2015Review
- The Role of End-of-Life Issues in the Design and Reporting of Cancer Clinical Trials: A Structured Literature Review.PloS one · 2015Review
- Medical expertise and patient involvement: a multiperspective qualitative observation study of the patient's role in oncological decision making.The oncologist · 2014Article
- Article
- "Double reflection": a practical approach to teach patient-doctor communication in oncology.The oncologist · 2013Article
Corrections and comments
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- Commented on byIn reply.2013
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurveys indicate considerable variation regarding the provision of cancer treatment at the end of life. The variation cannot be fully explained by differences concerning the clinical situation or patients' preferences. The aim of this qualitative study was to explore medical oncologists' experiences with advanced cancer, as well as their views of the relevance of medical and nonmedical criteria for decisions about limiting treatment.
methodsQualitative in-depth interviews were conducted with physicians working in medical oncology in tertiary care hospitals or district general hospitals in England. Purposive sampling and qualitative analysis were performed.
resultsPhysicians reported that a number of nonmedical factors influence professional decisions about the offering or limiting of cancer treatment in advanced cancer in addition to medical criteria. Physicians' individual judgments about the benefit of treatment, as well as the amount of their clinical experience, were cited as such factors. In addition, the physicians' perceptions of the patient's age and life circumstances were reported to influence their treatment decisions. Multiprofessional team discussions and the systematic collection of relevant clinical data regarding the outcomes of different treatment approaches in advanced cancer were suggested as strategies to improve the quality of treatment decisions.
conclusionThe findings of this study provide explanations for the variation in treatment in advanced cancer. Making value judgments explicit and gathering more appropriate clinical data on the outcomes of treatment near the end of life are prerequisites for improved ethical and evidence-based treatment decisions in advanced cancer.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.