| Titre : | Relationship between cancer patients'predictions of prognosis and their treatment preferences. (1998) |
| Auteurs : | J.C. WEEKS ; Afjr CONNORS ; E.F. COOK ; N.V. DAWSON ; F.E. HARRELL ; P. KUSSIN ; J. LYNN ; S.J. O'DAY ; L.M. PETERSON ; R.S. PHILLIPS ; D. REDING ; N. WENGER ; Department of Adult Oncology. Dana-Farber Cancer Institute. Boston Mass. USA ; Department of Medi-cine. Case Western Reserve University. MetroHealth Medical Center. Cleveland Ohio. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 279, n° 21, 1998) |
| Pagination : | 1709-1714 |
| Langues: | Anglais |
| Mots-clés : | Pronostic ; Thérapeutique ; Etude prospective ; Survie ; Etats Unis ; Amérique du Nord ; Amérique ; Homme ; Cancer |
| Résumé : | [BDSP. Notice produite par INIST jqaKR0xj. Diffusion soumise à autorisation]. Context. - Previous studies have documented that cancer patients tend to overestimate the probability of long-term survival. If patient preferences about the trade-offs between the risks and benefits associated with alternative treatment strategies are based on inaccurate perceptions of prognosis, then treatment choices may not reflect each patient's true values. Objective. - To test the hypothesis that among terminally ill cancer patients an accurate understanding of prognosis is associated with a preference for therapy that focuses on comfort over attempts at life extension. Design. - Prospective cohort study. Setting. - Five teaching hospitals in the United States. Patients. - A total of 917 adults hospitalized with stage III or IV non-small cell lung cancer or colon cancer metastatic to liver in phases 1 and 2 of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). Main Outcome Measures. - Proportion of patients favoring life-extending therapy over therapy focusing on relief of pain and discomfort, patient and physician estimates of the probability of 6-month survival, and actual 6-month survival. Results. - Patients who thought they were going to live for at least 6 months were more likely (odds ratio [OR], 2.6 ; 95% confidence interval [Cl], 1.8-3.7) to favor life-extending therapy over comfort care compared with patients who thought there was at least a 10% chance that they would not live 6 months. (...) |
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