Evidence map›Paper›PMID 27830393›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2017

Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study.

Martine T E Puts, Schroder Sattar, Kara McWatters, Katherine Lee, Michael Kulik, Mary-Ellen MacDonald, Raymond Jang, Eitan Amir, Monika K Krzyzanowska, Natasha Leighl and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Article
  7. Dyadic-concordance death-preparedness states and end-of-life care received by cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  8. Article
  9. Experiences of treatment decision-making among older newly diagnosed adults with acute myeloid leukemia: a qualitative descriptive study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  10. Article
  11. Review
  12. Observational
  13. Article
  14. Article
  15. Associations of prognostic-awareness-transition patterns with end-of-life care in cancer patients' last month.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Article
  16. Article
  17. Article
  18. National Survey Among Radiation Oncology Residents Related to Their Needs in Geriatric Oncology.Journal of cancer education : the official journal of the American Association for Cancer Education · 2019
    Article
  19. Article
  20. Shared decision-making in palliative care: desires and facts.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Martine T E PutsLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada. martine.puts@utoronto.ca.
Schroder SattarLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Kara McWattersLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Katherine LeeLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Michael KulikLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Mary-Ellen MacDonaldLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Raymond JangDepartment of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Eitan AmirDepartment of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Monika K KrzyzanowskaDepartment of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Natasha LeighlDepartment of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Margaret FitchLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Anthony M JoshuaKinghorn Cancer Centre and the Garvan Institute of Medical Research, University of Newsouth Wales, Sydney, Australia.
Padraig WardeDepartment of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Ann E TourangeauLawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street suite 130, Toronto, ON, M5T1P8, Canada.
Shabbir M H AlibhaiDepartment of Medicine and Institute of Health Policy, Management, and Evaluation, University Health Network and University of Toronto, Toronto, ON, Canada.

Funding

CIHR
6 · The paper itself

Abstract

purposeAlthough comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives.

methodsA mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis.

resultsThere was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved.

conclusionThis first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the older adult's or their family members' decision.

Indexed as

Decision MakingAgedAged, 80 and overAge FactorsCommunicationFamilyFemaleHumansLongitudinal StudiesMaleNeoplasmsOncologistsPhysicians, FamilyAgedComorbidityDecision makingFunctional statusGeriatric oncologyMixed methods study

Identifiers

PMID27830393
PMCPMC5266767

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.