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Patient‐hematologist discordance in perceived chance of cure in hematologic malignancies: A multicenter study
Author(s) -
Loh Kah Poh,
Xu Huiwen,
Back Anthony,
Duberstein Paul R.,
Gupta Mohile Supriya,
Epstein Ronald,
McHugh Colin,
Klepin Heidi D.,
Abel Gregory,
Lee Stephanie J.,
ElJawahri Areej,
LeBlanc Thomas W.
Publication year - 2020
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32656
Subject(s) - hematologist , medicine , hematologic neoplasms , hematologic malignancy , multicenter study , medline , intensive care medicine , pediatrics , cancer , disease , political science , law , randomized controlled trial
Background Ensuring that patients with hematologic malignancies have an accurate understanding of their likelihood of cure is important for informed decision making. In a multicenter, longitudinal study, the authors examined discordance in patients' perception of their chance of cure versus that of their hematologists, whether patient‐hematologist discordance changed after a consultation with a hematologist, and factors associated with persistent discordance. Methods Before and after consultation with a hematologist, patients were asked about their perceived chance of cure (options were <10%, 10%‐19%, and up to 90%‐100% in 10% increments, and “do not wish to answer”). Hematologists were asked the same question after consultation. Discordance was defined as a difference in response by 2 levels. The McNemar test was used to compare changes in patient‐hematologist prognostic discordance from before to after consultation. A generalized linear mixed model was used to examine associations between factors and postconsultation discordance, adjusting for clustering at the hematologist level. Results A total of 209 patients and 46 hematologists from 4 sites were included in the current study. Before consultation, approximately 61% of dyads were discordant, which improved to 50% after consultation ( P < .01). On multivariate analysis, lower educational level (