Measuring discord in treatment decision-making; progress toward development of a cancer communication and decision-making assessment tool

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

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Treatment Decision Making in Early-Stage Prostate Cancer: Evaluation of Computer-Based Patient Education and an Interactive Decision Aid

10.21236/ada415639 ◽

2003 ◽

Author(s):

Kathryn L. Taylor

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Patient Education ◽

Decision Aid ◽

Early Stage ◽

Treatment Decision ◽

Treatment Decision Making ◽

Computer Based

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Enhancing Involvement in Treatment Decision Making by Women with Breast Cancer

10.21236/ada473376 ◽

2007 ◽

Author(s):

Mary A. O'Brien ◽

Timothy Whelan ◽

Amiram Gafni ◽

Cathy Charles ◽

Peter Ellis

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Treatment Decision ◽

Treatment Decision Making

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Prostate Cancer Survivors with Rising PSA and Their Spouses: Treatment Decision Making and Quality of Life

10.21236/ada484327 ◽

2006 ◽

Author(s):

Michael A. Diefenbach

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Decision Making ◽

Cancer Survivors ◽

Treatment Decision ◽

Prostate Cancer Survivors ◽

Treatment Decision Making

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Enhancing Involvement in Treatment Decision Making by Women with Breast Cancer

10.21236/ada491137 ◽

2008 ◽

Author(s):

MaryAnn O'Brien

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Treatment Decision ◽

Treatment Decision Making

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Gene Expression Assay in the Management of Early Breast Cancer

Current Medicinal Chemistry ◽

10.2174/0929867326666191205163329 ◽

2020 ◽

Vol 27 (17) ◽

pp. 2826-2839 ◽

Cited By ~ 2

Author(s):

Roberta Caputo ◽

Daniela Cianniello ◽

Antonio Giordano ◽

Michela Piezzo ◽

Maria Riemma ◽

...

Keyword(s):

Breast Cancer ◽

Gene Expression ◽

Decision Making ◽

Adjuvant Chemotherapy ◽

Early Breast Cancer ◽

Treatment Decision ◽

Endocrine Treatment ◽

Expression Ratio ◽

Treatment Decision Making ◽

Low Sensitivity

The addition of adjuvant chemotherapy to hormonal therapy is often considered questionable in patients with estrogen receptor-positive early breast cancer. Low risk of disease relapse after endocrine treatment alone and/or a low sensitivity to chemotherapy are reasons behind not all patients benefit from chemotherapy. Most of the patients could be exposed to unnecessary treatment- related adverse events and health care costs when treatment decision-making is based only on classical clinical histological features. Gene expression profile has been developed to refine physician’s decision-making process and to tailor personalized treatment to patients. In particular, these tests are designed to spare patients the side effects of unnecessary treatment, and ensure that adjuvant chemotherapy is correctly recommended to patients with early breast cancer. In this review, we will discuss the main diagnostic tests and their potential clinical applications (Oncotype DX, MammaPrint, PAM50/Prosigna, EndoPredict, MapQuant Dx, IHC4, and Theros-Breast Cancer Gene Expression Ratio Assay).

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