Evidence map›Paper›PMID 28814131›Full record

ArticleMedical decision making : an international journal of the Society for Medical Decision Making2018

What Factors Influence Women's Perceptions of their Systemic Recurrence Risk after Breast Cancer Treatment?

Kamaria L Lee, Nancy K Janz, Brian J Zikmund-Fisher, Reshma Jagsi, Lauren P Wallner, Allison W Kurian, Steven J Katz, Paul Abrahamse, Sarah T Hawley

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Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–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

7 citing papers in PubMed.

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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

9 authors.

Kamaria L LeeDepartment of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA (KLL, BJZ, LPW, SJK, PA, STH).
Nancy K JanzDepartment of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA (NKJ, BJZ).
Brian J Zikmund-FisherDepartment of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA (KLL, BJZ, LPW, SJK, PA, STH).
Reshma JagsiDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA (RJ).
Lauren P WallnerDepartment of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA (KLL, BJZ, LPW, SJK, PA, STH).
Allison W KurianDepartments of Medicine and Health Research and Policy, Stanford University, Stanford, CA, USA (AWK).
Steven J KatzDepartment of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA (SJK, STH).
Paul AbrahamseDepartment of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA (KLL, BJZ, LPW, SJK, PA, STH).
Sarah T HawleyDepartment of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA (KLL, BJZ, LPW, SJK, PA, STH).

Funding

CALIFORNIA COORDINATED CANCER PREVENTION & CONTROL PROGRAMU58DP003862 · DP · CALIFORNIA STATE DEPT OF PUBLIC HEALTH · PI SNIPES, KURT P · 2012 to 2014
$31.5M
GEORGIA COMPREHENSIVE CANCER CONTROL PROGRAMU58DP003875 · DP · GEORGIA DIVISION OF PUBLIC HEALTH · PI O'CONNOR, JEAN CATHERINE · 2012 to 2014
$15.9M
The Challenge of Individualizing Treatments for Patients with Breast CancerP01CA163233 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOFER, TIMOTHY P. · 2012 to 2016
$13.4M
CCR NIH HHS HHSN261201300015CNCCDPHP CDC HHS U58 DP003862NCCDPHP CDC HHS U58 DP003875NCI NIH HHS HHSN261201000034CNCI NIH HHS HHSN261201000035CNCI NIH HHS HHSN261201000035INCI NIH HHS HHSN261201000140CNCI NIH HHS P01 CA163233
6 · The paper itself

Abstract

backgroundBreast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. Little is known about how women derive their risk estimates.

methodsUsing Los Angeles and Georgia's SEER registries (2014-2015), a random sample of early-stage breast cancer patients was sent surveys about 2 to 3 months after surgery ( N = 3930; RR, 68%). We conducted an inductive thematic analysis of open-ended responses about why women chose their risk estimates in a uniquely large sub-sample ( N = 1,754). Clinician estimates of systemic recurrence risk were provided for patient sub-groups with DCIS and with low-, intermediate-, and high-risk invasive disease. Women's perceived risk of systemic recurrence (0% to 100%) was categorized as overestimation, reasonably accurate estimation, or underestimation (0% for invasive disease) and was compared across identified factors and by clinical presentation.

resultsWomen identified 9 main factors related to their clinical experience (e.g., diagnosis and testing; treatment) and non-clinical beliefs (e.g., uncertainty; spirituality). Women who mentioned at least one clinical experience factor were significantly less likely to overestimate their risk (12% v. 43%, P < 0.001). Most women who were influenced by "communication with a clinician" had reasonably accurate recurrence estimates (68%). "Uncertainty" and "family and personal history" were associated with overestimation, particularly for women with DCIS (75%; 84%). "Spirituality, religion, and faith" was associated with an underestimation of risk (63% v. 20%, P < 0.001). LIMITATIONS: The quantification of our qualitative results is subject to any biases that may have occurred during the coding process despite rigorous methodology.

conclusionsPatient-clinician communication is important for breast cancer patients' understanding of their numeric risk of systemic recurrence. Clinician discussions about recurrence risk should address uncertainty and relevance of family and personal history.

Indexed as

PerceptionAdultAgedBreast NeoplasmsCommunicationDecision MakingFemaleHumansMiddle AgedNeoplasm Recurrence, LocalPhysician-Patient RelationsRisk AssessmentSEER ProgramSpiritualityUncertaintyYoung Adultbreast cancerqualitative methodsrisk communicationrisk perceptionsystemic recurrence

Identifiers

PMID28814131
PMCPMC5764769

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.