Evidence map›Paper›PMID 38341898›Full record

ArticlePatient education and counseling2024

Balancing risks and rewards: How hematologists discuss uncertainty in allogeneic hematopoietic cell transplantation outcomes.

Rachel A Rodenbach, Thorunn Thordardottir, Markus Brauer, Aric C Hall, Earlise Ward, Cardinale B Smith, Toby C Campbell

Open access · greenAbstract read
In one paragraph

Article in Patient education and counseling, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
2.3field-weighted citation impact, top 13% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. 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

7 authors at 3 institutions in 1 country.

Rachel A RodenbachUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA. Electronic address: rachel_rodenbach@urmc.rochester.edu.
Thorunn ThordardottirUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA.
Markus BrauerUniversity of Wisconsin Department of Psychology, Madison, WI, USA.
Aric C HallUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA.
Earlise WardUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA; University of Wisconsin School of Medicine and Public Health, Department of Family Medicine and Community Health, Madison, WI, USA.
Cardinale B SmithIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Toby C CampbellUniversity of Wisconsin Carbone Cancer Center, Madison, WI, USA.
University of Wisconsin Carbone Cancer Center · USIcahn School of Medicine at Mount Sinai · USUniversity of Wisconsin–Madison · US

Funding

RESEARCH TRAINING IN HEMATOLOGYT32HL007899 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI Jane Ellen Churpek · 1998 to 2026
$8.2M
NHLBI NIH HHS T32 HL007899
6 · The paper itself

Abstract

objectiveAllogeneic hematopoietic cell transplant (alloHCT) offers many patients with blood cancers a chance of cure but carries risks. We characterized how hematologists discuss the high-risk, high-reward concept of alloHCT.

methodsQualitative analysis of video-recorded virtual encounters of hematologists who routinely perform alloHCT with actors portraying an older man recently diagnosed with high-risk myelodysplastic syndrome.

resultsHematologists (n = 37) were a median age of 44 years, 65% male, and 68% white. They frequently used "teeter-totter" language that juxtaposed alloHCT's risks and rewards in a dynamic, quickly alternating fashion and communicated uncertainty in transplant outcomes. This dialogue oscillated between encouragement about alloHCT's potential for cure and caution about its risks and occurred within single speech turns and in exchanges between hematologist and patient. Fewer hematologists outlined their big-picture stance on transplant's risks and benefits early in the conversation. Meanwhile, hematologists varied in how they counseled patients to manage transplant-related uncertainty and consider treatment decision making.

conclusionHematologists use "teeter-totter" language to express hope and concern, confidence and uncertainty, and encouragement and caution about the high-risk, high-reward nature of alloHCT. PRACTICE IMPLICATIONS: Teeter-totter language may help frame big-picture content about alloHCT's risks and benefits that is essential for patient education and decision making.

Indexed as

Hematologic NeoplasmsHematopoietic Stem Cell TransplantationAdultFemaleHumansMaleUncertaintyAllogeneic hematopoietic cell transplantationDecision makingHematologyPhysician-patient communicationRisk-benefit discussionUncertainty

Identifiers

PMID38341898
PMCPMC10997451
OpenAlexW4391451061

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.