scholarly journals Testing the Effects of Modality and Narration Style on Patients’ Information Use in a Lung Cancer Treatment Decision Aid

2020 ◽  
Vol 40 (8) ◽  
pp. 990-1002
Author(s):  
Nida Gizem Yılmaz ◽  
Julia C. M. Van Weert ◽  
Ellen Peters ◽  
Birgit I. Lissenberg-Witte ◽  
Annemarie Becker ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Information Processing ◽  
Cognitive Load ◽  
Cancer Treatment ◽  
Older Patients ◽  
Decision Aid ◽  
Treatment Decision ◽  
Decisional Conflict ◽  
Factual Information ◽  
Younger Patients

Background Risk information in patient decision aids (PDAs) is often difficult for older patients to process. Providing audiovisual and narrative information may enhance the understanding and use of health-related information. We studied the effects on patients’ information processing and use of audiovisual and narrative information of an early-stage non–small-cell lung cancer treatment decision aid explaining surgery and stereotactic ablative radiotherapy. We further investigated differences between older and younger patients. Methods We conducted a 2 (modality: textual v. audiovisual) × 2 (narration style: factual v. narrative) online experiment among cancer patients and survivors ( N = 305; Mage = 62.42, SD = 11.68 y). Age was included as a potential modifier: younger (<65 y) versus older (≥65 y) age. We assessed 1) perceived cognitive load, 2) satisfaction with information, 3) comprehension, 4) information recall, and 5) decisional conflict. Analysis of variance was used for data analysis. Results Irrespective of patient age, audiovisual information (compared with textual information) led to lower perceived cognitive load, higher satisfaction with information, and lower decisional conflict (subscale Effective Decision). Narrative information (compared with factual information) led to reduced decisional conflict (subscale Uncertainty) but only in younger patients. Combining audiovisual information with factual information also resulted in lower perceived cognitive load in younger patients as compared with older patients. Limitations Patients who actually face the decision, especially older patients, might be more motivated to process our decision-aid information than the present study participants who responded to a hypothetical situation online. Conclusions Providing participants with audiovisual information, irrespective of their age, improved their processing and use of information in a decision aid. Narratives did not clearly benefit information processing.

Effect of age on impact of adjuvant chemotherapy for resected non-small cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7539-7539
Author(s):  
Apar Kishor Ganti ◽  
Christina D. Williams ◽  
Ajeet Gajra ◽  
Michael J. Kelley
Keyword(s):  
Lung Cancer ◽  
Adjuvant Chemotherapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Older Patients ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Younger Patients ◽  
Stage 1

7539 Background: Adjuvant chemotherapy (AC) is considered standard of care in patients with resected stages 2 and 3 non-small cell lung cancer (NSCLC). However data regarding its utility in older patients are sparse. This analysis was conducted to evaluate the role of AC in older patients with early stage NSCLC. Methods: We conducted a retrospective analysis of patients with stages 1-3 NSCLC between 2001 and 2008 in the VA Central Cancer Registry. Patients were divided into two groups based on age: <70 yrs and ≥70 yrs. Descriptive statistics were used to examine patterns of AC use and to obtain survival rates associated with use of AC in the two age groups. Chi-square was used to compare distributions. Results: Of the 10,036 patients who underwent surgical resection, 3958 (39.4%) were ≥70 yrs, while 6078 were <70 yrs old. Overall, 11.2% of older patients (6.3% - stage 1, 21% - stage 2, 26.2% - stage 3) and 22.3% of younger pts (11.6% - stage 1, 41.1% - stage 2, 47.1% - stage 3) received AC. Of the patients who received AC, a greater proportion of younger patients received platinum-based AC (91.8 vs 86.4% vs; p=0.0008). Also, in each stage younger patients had a better 3 yr overall survival (OS) (Stage 1-69.2 vs 58%, stage 2 – 52.8 vs 39.1%, stage 3 – 42.5 vs 33.7%). Younger patients with stages 2 and 3 NSCLC who received AC had improved 3 yr OS (58.8 vs 48.6%; p=0.0009 and 48.8 vs 36.9%; p=0.0002 respectively). There was no difference in 3 yr OS for older patients based on AC when all stages were included. For patients with stages 2 and 3, a larger proportion of younger patients received cisplatin-based AC (11.3 vs 3.5%). Older patients with stages 2 and 3, who received cisplatin-based AC had a better 3 yr OS compared to those who received carboplatin-based AC or no AC (55.3 vs 42.2 vs 35.3% respectively; p=0.01). Similarly cisplatin-based AC had an improved 3 yr OS in younger patients with stages 2 and 3 NSCLC (61.4 vs 52 vs 43.4% respectively; p=0.0001). Conclusions: This analysis suggests that older patients do not benefit from AC after resection of stage 1-3 NSCLC to the same degree as younger patients. This differential effect may be due to less common use of cisplatin among older patients. Multivariate analyses are planned.

Clinical Characteristics and Surgery of Primary Lung Cancer in Younger Patients

2008 ◽  
Vol 16 (5) ◽  
pp. 387-391 ◽  
Author(s):  
Yasunobu Funakoshi ◽  
Shin-Ichi Takeda ◽  
Yoshihisa Kadota ◽  
Takashi Kusu ◽  
Hajime Maeda
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Early Stage ◽  
Survival Rates ◽  
Primary Lung Cancer ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Younger Patients

Controversy exists regarding the clinical characteristics, pathological findings, and prognosis of patients < 50 years of age with primary lung cancer. The medical records of 4,556 patients diagnosed with primary lung cancer between 1980 and 2004 were reviewed; of these, 305 were < 50 years old. Of 1,335 patients who were surgically treated, 122 were < 50 years old. Females were over-represented in the younger group. Younger patients had a significantly higher incidence of adenocarcinoma and large cell carcinoma, and a lower incidence of squamous cell carcinoma. The resectable rate in younger patients was significantly higher. Overall and among surgically treated patients, the survival rates of younger patients with stage 0-I disease were significantly better than those of older patients. Younger patients with early-stage primary lung cancer had a significantly better prognosis than older patients, although survival in the advanced stages was not significantly different.

scholarly journals Uptake and usage of an online prostate cancer treatment decision aid in Dutch clinical practice: A quantitative analysis from the Prostate Cancer Patient Centered Care trial

2018 ◽  
Vol 25 (4) ◽  
pp. 1498-1510 ◽  
Author(s):  
Maarten Cuypers ◽  
Romy ED Lamers ◽  
Paul JM Kil ◽  
Julia J van Tol-Geerdink ◽  
Cornelia F van Uden-Kraan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patient ◽  
Cancer Treatment ◽  
Decision Aid ◽  
Prostate Cancer Patient ◽  
Decision Aids ◽  
Treatment Decision ◽  
Patient Centered ◽  
Prostate Cancer Treatment ◽  
Centered Care

Implementation of patient’s decision aids in routine clinical care is generally low. This study evaluated uptake and usage of a novel Dutch web-based prostate cancer treatment decision aid within the Prostate Cancer Patient Centered Care trial. From an estimated total patient sample of 1006 patients, 351 received a decision aid (35% implementation rate; hospital ranges 16%–84%). After receipt of the decision aid, most patients accessed the decision aid, utilized most functions, although not completely, and discussed the decision aid summary in a subsequent consultation with their care provider. Including nurses for dissemination of decision aids seemed to positively affect decision aid uptake. Once received, patients seemed able to use the decision aid and engage in shared decision-making as intended; however, decision aid uptake and complete usage of all decision aid components should be further improved. Prior to the diagnosis consultation, handing out of the decision aid should be prepared.

scholarly journals Impact of Age and Comorbidity on Non–Small-Cell Lung Cancer Treatment in Older Veterans

2012 ◽  
Vol 30 (13) ◽  
pp. 1447-1455 ◽  
Author(s):  
Sunny Wang ◽  
Melisa L. Wong ◽  
Nathan Hamilton ◽  
J. Ben Davoren ◽  
Thierry M. Jahan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Cancer Treatment ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Older Patients ◽  
Small Cell ◽  
Small Cell Lung ◽  
Recommended Treatment ◽  
Severe Comorbidity

Purpose Because comorbidity affects cancer treatment outcomes, guidelines recommend considering comorbidity when making treatment decisions in older patients with lung cancer. Yet, it is unclear whether treatment is targeted to healthier older adults who might reasonably benefit. Patients and Methods Receipt of first-line guideline-recommended treatment was assessed for 20,511 veterans age ≥ 65 years with non–small-cell lung cancer (NSCLC) in the Veterans Affairs (VA) Central Cancer Registry from 2003 to 2008. Patients were stratified by age (65 to 74, 75 to 84, ≥ 85 years), Charlson comorbidity index score (0, 1 to 3, ≥ 4), and American Joint Committee on Cancer stage (I to II, IIIA to IIIB, IIIB with malignant effusion to IV). Comorbidity and patient characteristics were obtained from VA claims and registry data. Multivariate analysis identified predictors of receipt of guideline-recommended treatment. Results In all, 51% of patients with local, 35% with regional, and 27% with metastatic disease received guideline-recommended treatment. Treatment rates decreased more with advancing age than with worsening comorbidity for all stages, such that older patients with no comorbidity had lower rates than younger patients with severe comorbidity. For example, 50% of patients with local disease age 75 to 84 years with no comorbidity received surgery compared with 57% of patients age 65 to 74 years with severe comorbidity (P < .001). In multivariate analysis, age and histology remained strong negative predictors of treatment for all stages, whereas comorbidity and nonclinical factors had a minor effect. Conclusion Advancing age is a much stronger negative predictor of treatment receipt among older veterans with NSCLC than comorbidity. Individualized decisions that go beyond age and include comorbidity are needed to better target NSCLC treatments to older patients who may reasonably benefit.

627 A RANDOMIZED PILOT STUDY TO ASSESS ANXIETY RELATED TO DISTRIBUTING A PROSTATE CANCER TREATMENT DECISION AID PRIOR TO BIOPSY

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Steven Zeliadt ◽  
Laura Bonner ◽  
Ranak Trivedi ◽  
Crystal Kimmie ◽  
Peggy Hannon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pilot Study ◽  
Cancer Treatment ◽  
Decision Aid ◽  
Treatment Decision ◽  
Prostate Cancer Treatment
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