Evidence map›Paper›PMID 31899375›Full record

ArticleThe spine journal : official journal of the North American Spine Society2020

Patient experiences of decision-making in the treatment of spinal metastases: a qualitative study.

Emma C Lape, Jeffrey N Katz, Justin A Blucher, Angela T Chen, Genevieve S Silva, Joseph H Schwab, Tracy A Balboni, Elena Losina, Andrew J Schoenfeld

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The spine journal : official journal of the North American Spine Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 12% of its field
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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Evaluating ambulatory function as an outcome following treatment for spinal metastases: a systematic review.The spine journal : official journal of the North American Spine Society · 2021
    Pooled it
  3. Article
  4. Predicting 30-day mortality after surgery for metastatic disease of the spine: the HEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023
    Article
  5. Randomized controlled trials and high-intensity spine surgery.The spine journal : official journal of the North American Spine Society · 2020
    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

9 authors at 3 institutions in 1 country.

Emma C LapeDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Jeffrey N KatzDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Justin A BlucherDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Angela T ChenDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Genevieve S SilvaDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Joseph H SchwabDepartment of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02214, USA.
Tracy A BalboniDepartment of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Elena LosinaDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Andrew J SchoenfeldDepartment of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. Electronic address: ajschoen@neomed.edu.
Harvard University · USBrigham and Women's Hospital · USMassachusetts General Hospital · US

Funding

VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Elena Losina · 2017 to 2026
$9.8M
Patient Oriented Research and Mentoring Program in OrthopedicsK24AR057827 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSINA, ELENA · 2010 to 2019
$1.7M
Optimizing Surgical Interventions for Patients with Spinal Metastases: A Mixed-Methods StudyK23AR071464 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI SCHOENFELD, ANDREW · 2017 to 2021
$890k
NIAMS NIH HHS K23 AR071464NIAMS NIH HHS K24 AR057827NIAMS NIH HHS P30 AR072577
6 · The paper itself

Abstract

backgroundIn the treatment of spinal metastases the risks of surgery must be balanced against potential benefits, particularly in light of limited life-expectancy. Patient experiences and preferences regarding decision-making in this context are not well explored. PURPOSE: We performed a qualitative study involving patients receiving treatment for spinal metastatic disease. We sought to understand factors that influenced decision-making around care for spinal metastases. STUDY

settingThree tertiary academic medical centers. PATIENT SAMPLE: We recruited patients presenting for treatment of spinal metastatic disease at one of three tertiary centers in Boston, MA. OUTCOME MEASURES: We conducted semistructured interviews using a guide that probed participants' experiences with making treatment decisions.

methodsWe performed a thematic analysis that produced a list of themes, subthemes, and statement explaining how the themes related to the study's guiding questions. Patients were recruited until thematic saturation was reached.

resultsWe interviewed 23 participants before reaching thematic saturation. The enormity of treatment decisions, and of the diagnosis of spinal metastases itself, shaped participant preferences for who should take responsibility for the decision and whether to accept treatments bearing greater risk of complications. Pre-existing participant beliefs about decision-making and about surgery interacted with the clinical context in a way that tended to promote accepting physician recommendations and delaying or avoiding surgery.

conclusionsThe diagnosis of spinal metastatic disease played an outsized role in shaping participant preferences for agency in treatment decision-making. Further research should address strategies to support patient understanding of treatment options in clinical contexts-such as spinal metastases-characterized by ominous underlying disease and high-risk, often urgent interventions.

Indexed as

Spinal NeoplasmsConservative TreatmentDecision MakingFemaleHumansMaleMiddle AgedPatient Outcome AssessmentQualitative ResearchRenal DialysisDecision makingProvider communicationQualitative researchRadiation oncologySpinal metastasesSurgical management

Identifiers

PMID31899375
PMCPMC7246131
OpenAlexW2998096003

What OpenQuestion holds

Textmetadata
LicenceTDM
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.