Evidence map›Paper›PMID 29221485›Full record

Observational studyBMC palliative care2017

Exploring the characteristics of patients with mesothelioma who chose active symptom control over chemotherapy as first-line treatment: a prospective, observational, single centre study.

Anna C Bibby, Duneesha De Fonseka, Anna J Morley, Emma Keenan, Alfredo Addeo, Sarah Smith, Anthony J Edey, Nick A Maskell

Abstract readObservational Study
In one paragraph

Observational study in BMC palliative care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. 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

8 authors.

Anna C BibbyAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, 2nd Floor L&R Building, Bristol, BS10 5NB, UK. Anna.Bibby@bristol.ac.uk.ORCID http://orcid.org/0000-0001-7386-7754
Duneesha De FonsekaAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, 2nd Floor L&R Building, Bristol, BS10 5NB, UK.
Anna J MorleyDepartment of Respiratory Medicine, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK.
Emma KeenanAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, 2nd Floor L&R Building, Bristol, BS10 5NB, UK.
Alfredo AddeoBristol Cancer Institute, Bristol Haematology & Oncology Centre, Horfield Rd, Bristol, BS2 8ED, UK.
Sarah SmithDepartment of Respiratory Medicine, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK.
Anthony J EdeyDepartment of Radiology, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK.
Nick A MaskellAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, 2nd Floor L&R Building, Bristol, BS10 5NB, UK.

Funding

North Bristol NHS Trust Research Capability Fund n/a
6 · The paper itself

Abstract

backgroundMesothelioma is an aggressive thoracic tumour with a poor prognosis. The only treatment that extends survival is chemotherapy. However, in the UK, up to 50% of patients who are suitable for chemotherapy choose not to receive it, opting for active symptom control instead. The aim of this prospective, single-centre observational study was to describe the characteristics of patients who chose active symptom control over chemotherapy and explore their reasons for doing so.

methodsTwo hundred consecutive patients with mesothelioma from one UK centre were included. Eligibility for chemotherapy and choice of first-line treatment were recorded prospectively. Patient characteristics and outcomes were compared using descriptive statistics, regression analysis and survival analysis. Reasons for choosing active symptom control over chemotherapy were extracted, retrospectively.

resultsPeople who chose active symptom control were older, more likely to be female and had worse performance statuses than patients who received front-line chemotherapy. Concern over side effects, the modest survival benefit and previous adverse experiences with chemotherapy were reported as reasons for the decision. Median survival was 13.9 months in the chemotherapy group compared with 6.7 months in the active symptom control group.

conclusionsThis is the first study to describe the characteristics of patients with mesothelioma who chose active symptom control over chemotherapy, in the front-line setting. Important differences were seen between this group and patients who received chemotherapy, although confounding is likely to have affected some outcomes. Future research could use qualitative methods to explore patients' reasons for choosing active symptom control, and to further elucidate the decision-making process.

Indexed as

Choice BehaviorSymptom Flare UpAgedDrug Therapy, CombinationFemaleHumansMaleMesotheliomaMiddle AgedProspective StudiesRetrospective StudiesSurvival AnalysisUnited KingdomActive symptom controlBest supportive careChemotherapyMesotheliomaTreatment decisions

Identifiers

PMID29221485
PMCPMC5723074

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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.