Evidence map›Paper›PMID 33354736›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021

Treatment goals and changes over time in older patients with non-curable cancer.

M E Stegmann, D Brandenbarg, A K L Reyners, W H van Geffen, T J N Hiltermann, A J Berendsen

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing 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

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

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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

6 authors.

M E StegmannDepartment of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA 21, 9713 AV, Groningen, The Netherlands. m.e.stegmann@umcg.nl.ORCID https://orcid.org/0000-0001-8491-1407
D BrandenbargDepartment of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA 21, 9713 AV, Groningen, The Netherlands.
A K L ReynersDepartment of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
W H van GeffenDepartment of Pulmonary Diseases, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
T J N HiltermannDepartment of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
A J BerendsenDepartment of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA 21, 9713 AV, Groningen, The Netherlands.

Funding

KWF Kankerbestrijding RUG 2014-7273
6 · The paper itself

Abstract

purposeTo investigate the treatment goals of older patients with non-curable cancer, whether those goals changed over time, and if so, what triggered those changes.

methodsWe performed a descriptive and qualitative analysis using the Outcome Prioritization Tool (OPT) to assess patient goals across four conversations with general practitioners (GPs) over 6 months. Text entries from electronic patient records (hospital and general practice) were then analyzed qualitatively for this period.

resultsOf the 29 included patients, 10 (34%) rated extending life and 9 (31%) rated maintaining independence as their most important goals. Patients in the last year before death (late phase) prioritized extending life less often (3 patients; 21%) than those in the early phase (7 patients; 47%). Goals changed for 16 patients during follow-up (12 in the late phase). Qualitative analysis revealed three themes that explained the baseline OPT scores (prioritizing a specific goal, rating a goal as unimportant, and treatment choices related to goals). Another three themes related to changes in OPT scores (symptoms, disease course, and life events) and stability of OPT scores (stable situation, disease-unrelated motivation, and stability despite symptoms).

conclusionPatients most often prioritized extending life as the most important goal. However, priorities differed in the late phase of the disease, leading to changed goals. Triggers for change related to both the disease (e.g., symptoms and course) and to other life events. We therefore recommend that goals should be discussed repeatedly, especially near the end of life.

trial registrationOPTion study: NTR5419.

Indexed as

AgedAged, 80 and overFemaleGoalsHumansMaleNeoplasmsTime FactorsAgedDecision-makingGoalsNeoplasmsPalliative carePrimary health care

Identifiers

PMID33354736
PMCPMC8163677

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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.