Evidence map›Paper›PMID 31781946›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020

Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients.

M E S Smith-Uffen, S B Johnson, A J Martin, M H N Tattersall, M R Stockler, M L Bell, K Detering, J M Clayton, W Silvester, S Clarke and 3 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

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

  1. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5).Annals of oncology : official journal of the European Society for Medical Oncology · 2020
    Guideline
  2. Article
  3. Review
  4. Article
  5. Article
  6. Using three scenarios to explain life expectancy in advanced cancer: attitudes of patients, family members, and other healthcare professionals.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Article
  7. Article
  8. Exploring the needs and experiences of palliative home care from the perspectives of patients with advanced cancer in China: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Article
  9. Review
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

13 authors.

M E S Smith-UffenDepartment of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia.
S B JohnsonDepartment of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia.
A J MartinNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
M H N TattersallDepartment of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia.
M R StocklerNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
M L BellMel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
K DeteringAdvance Care Planning Department, Austin Hospital, Melbourne, Victoria, Australia.
J M ClaytonHammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, New South Wales, Australia.
W SilvesterUniversity of Melbourne, Melbourne, Victoria, Australia.
S ClarkeKolling Institute of Medical Research, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.
L VaccaroDepartment of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia.
P BealeDepartment of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia.
B E KielyNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia. belinda.kiely@ctc.usyd.edu.au.

Funding

VITAMIN AP30CA023074 · NCI · UNIVERSITY OF ARIZONA · PI Teri L Bankhead · 1985 to 2026
$110.2M
6 · The paper itself

Abstract

purposeTo compare estimates of expected survival time (EST) made by patients with advanced cancer and their oncologists.

methodsAt enrolment patients recorded their "understanding of how long you may have to live" in best-case, most-likely, and worst-case scenarios. Oncologists estimated survival time for each of their patients as the "median survival of a group of identical patients". We hypothesized that oncologists' estimates of EST would be unbiased (~ 50% longer or shorter than the observed survival time [OST]), imprecise (< 33% within 0.67 to 1.33 times OST), associated with OST, and more accurate than patients' estimates of their own survival.

resultsTwenty-six oncologists estimated EST for 179 patients. The median estimate of EST was 6.0 months, and the median OST was 6.2 months. Oncologists' estimates were unbiased (56% longer than OST), imprecise (27% within 0.67 to 1.33 times OST), and significantly associated with OST (HR 0.88, 95% CI 0.82 to 0.93, p < 0.01). Only 41 patients (23%) provided a numerical estimate of their survival with 107 patients (60%) responding "I don't know". The median estimate by patients for their most-likely scenario was 12 months. Patient estimates of their most-likely scenario were less precise (17% within 0.67 to 1.33 times OST) and more likely to overestimate survival (85% longer than OST) than oncologist estimates.

conclusionOncologists' estimates were unbiased and significantly associated with survival. Most patients with advanced cancer did not know their EST or overestimated their survival time compared to their oncologist, highlighting the need for improved prognosis communication training. Trial registration ACTRN1261300128871.

Indexed as

AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasmsOncologistsPrognosisProspective StudiesSurvival AnalysisAdvanced cancerAdvanced care planningExpected survival timePrognosticationSurvival estimateSurvival scenario

Identifiers

PMID31781946

What OpenQuestion holds

Textmetadata
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.