ArticleHealth expectations : an international journal of public participation in health care and health policy2015
Barriers to shared decisions in the most serious of cancers: a qualitative study of patients with pancreatic cancer treated in the UK.
Article in Health expectations : an international journal of public participation in health care and health policy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Inoperable malignant bowel obstruction: palliative interventions outcomes - mixed-methods systematic review.BMJ supportive & palliative care · 2024Pooled it
- Fostering Patient Choice Awareness and Presenting Treatment Options Neutrally: A Randomized Trial to Assess the Effect on Perceived Room for Involvement in Decision Making.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Trial
- Review
- "It's Either Have Surgery or Die": How Patients Perceive the Choice to Undergo High-Risk Abdominal Surgery for Cancer.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Expanding perspectives on informed decision-making in pancreatic cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Examining health system stakeholder-reported barriers and solutions to foregut cancer care.American journal of surgery · 2026Article
- Assessing Clinical Factors and Communication Barriers Impacting Postoperative Regret in Patients with Pancreatic Cancer.Annals of surgical oncology · 2026Article
- How doctors present treatment options in advanced lung cancer consultations: a conversation analytic study.BMJ open respiratory research · 2026Article
- A Grounded Theory of the Lived Experiences of People with Pancreatic Cancer in Northern Ireland: Study Protocol.Healthcare (Basel, Switzerland) · 2025Article
- Factors impacting informed decision-making for patients with pancreatic cancer: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- From Burden to Empowerment. Patient-Reported Influencing Factors on Participation in Shared Decision Making in Oncology, a Meta-Study.Psycho-oncology · 2025Review
- Nationwide implementation of the international multidisciplinary best-practice for locally advanced pancreatic cancer (PREOPANC-4): study protocol.BMC cancer · 2025Article
- Have a vital end-user been overlooked? Developing a shared decision intervention for patients with potential pancreatic cancer regarding the choice of surgery.PEC innovation · 2024Article
- Toward a new paradigm of care: a surgical leaders' Delphi consensus on the organizational factors of the new pancreas units (E-AHPBA PUECOF study).Updates in surgery · 2024Article
- Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2024Review
- Shared Decision-Making in Pancreatic Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
- Patient-centered outcomes for gastrointestinal cancer care: a scoping review protocol.BMJ open · 2022Article
- Development, Testing, and Implementation of the Belgian Patient Reported Experience Measure for Pancreatic Cancer Care (PREPARE) Project: Protocol for a Multi-Method Research Project.JMIR research protocols · 2022Article
- Article
- The patient's perspective: a qualitative study of individual experience with decision-making, treatment, and recovery for resectable pancreatic cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLess than 20% of patients with pancreatic cancer present with localized, potentially curable tumours. Even when potentially curative surgery is possible, mortality is high. Only 20-25% of patients who have had resected ductal adenocarcinoma of the pancreatic head survive 5 years. Other treatments include chemotherapy, radiotherapy and palliative care.
aimTo explore patients' perceptions of barriers to shared decision making in a condition in which shared decision making might be difficult.
methodThematic analysis of narrative interviews with 32 people diagnosed with pancreatic cancer in the UK; interviews with a social scientist, usually in people's homes.
resultsWe found that barriers to shared decisions include the idea that investigations are conducted to determine whether the patient qualifies for surgery, rather than to establish whether surgery is an option to consider; a sense of being pressured to accept treatment, a sense that in a life-threatening situation, there are no 'real options'; and the confusion that can be caused when clinical opinions differ.
conclusionWe need to ask how patients can be expected to engage in an informed, shared decision if they are made to feel that they are one of the 'winners' if they qualify for surgery. When each treatment decision might have serious consequences for a patient's remaining months, we suggest that there is a particularly strong imperative to make sure that the patient is not subject to other people's assumptions about what is best for them and that patients are offered the opportunity to share in decisions.
Indexed as
Identifiers
What OpenQuestion holds
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.