%0 Journal Article
%T Oncologist use of the Adjuvant! model for risk communication: a pilot study examining patient knowledge of 10-year prognosis
%A Jeffrey K Belkora
%A Hope S Rugo
%A Dan H Moore
%A David W Hutton
%A Daniel F Chen
%A Laura J Esserman
%J BMC Cancer
%D 2009
%I BioMed Central
%R 10.1186/1471-2407-9-127
%X We recruited a convenience sample of 20 patients seen by 2 senior oncologists using Adjuvant! printouts of recurrence and mortality screens in our academic medical center. We asked patients for their estimates of local therapy recurrence and mortality risks and counted the number of patients whose estimates were within ¡À 5% of Adjuvant! before and after the oncology visit, testing whether pre/post changes were significant using McNemar's two-sided test at a significance level of 5%.Two patients (10%) accurately estimated local therapy recurrence and mortality risks before the oncology visit, while seven out of twenty (35%) were accurate afterwards (p = 0.125).A majority of patients in our sample were inaccurate in estimating their local therapy recurrence and mortality risks, even after being shown printouts summarizing these risks during their oncology visits. Larger studies are needed to replicate or repudiate these preliminary findings, and test alternative methods of presenting risk estimates. Meanwhile, oncologists should be wary of relying exclusively on Adjuvant! printouts to communicate local therapy recurrence and mortality estimates to patients, as they may leave a majority of patients misinformed.In 2007, an estimated 178,480 new cases of invasive breast cancer were diagnosed among US women and approximately 40,460 died from the disease [1]. To reduce the risks of progression, recurrence, and ultimately mortality, adjuvant therapies such as chemotherapy and hormone therapy are often recommended in addition to local therapies such as surgery and radiation.These therapies have uncertain outcomes. For example, prior studies indicate that some chemotherapy regimens carry approximately a 0.5% chance of treatment-induced leukemia [2] in addition to increases in 10-year absolute survival ranging from 2¨C11% for most breast cancer patients [3]. Oncologists must communicate these and other uncertain outcomes to patients in order to assure that treatment decisions a
%U http://www.biomedcentral.com/1471-2407/9/127