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Patient-Driven Second Opinions in Oncology: A Systematic Review
Marij A Hillen1, Niki M Medendorp2, Joost G Daams3
1Department of Medical Psychology, Amsterdam, The Netherlands M.A.Hillen@amc.uva.nl.
The Oncologist
|June 14, 2017
Summary
Cancer patients increasingly seek second opinions for various reasons, including a need for certainty and better communication. However, the overall benefits and optimal facilitation of this process require further investigation.
Area of Science:
- Oncology
- Patient-centered care
- Health services research
Background:
- Patient-driven second opinions in oncology are rising.
- The desirability and impact of this trend are not well understood.
Purpose of the Study:
- To systematically review evidence on patient motivations for seeking second opinions in oncology.
- To examine the frequency, evolution, and consequences of these requests on oncological practice.
Main Methods:
- Systematic review of peer-reviewed articles on patient-initiated second opinions in oncology.
- Searched databases using terms: "cancer," "second opinion," and "self-initiated."
- Two researchers performed selection, data extraction, and quality assessment.
Main Results:
- Included 25 studies (4 qualitative, 1 mixed, 20 quantitative).
- Second opinion seeking rates varied widely (1%-88%), with higher education being a consistent correlate.
- Primary patient motivations included need for certainty, trust issues, communication dissatisfaction, and desire for more personalized information.
- Discrepancies between first and second opinions ranged from 2%-51%.
Conclusions:
- The benefits of cancer patient second opinions remain unclear.
- Studies vary significantly in methodology and quality.
- Further research is needed to understand consequences and guide patients/physicians, with practical recommendations for oncologists provided.
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