Communication Frameworks for Palliative Surgical Consultations: A Randomized Study of Advanced Cancer Patients.

Area of Science:

• Medical Communication
• Surgical Decision-Making
• Oncology

Background:

• Effective communication is crucial for patient satisfaction and outcomes in palliative care.
• Understanding patient preferences for communication frameworks aids in shared decision-making.

Purpose of the Study:

• To compare patient preference for the best case/worst case (BC/WC) communication framework versus the traditional risk/benefit (R/B) framework in palliative surgical scenarios for advanced cancer patients.

Main Methods:

• A randomized, double-blinded study using video vignettes presented to patients with advanced cancer.
• Patients viewed scenarios where surgeons used either BC/WC or R/B frameworks to discuss palliative surgery options.
• Primary outcome measured was the patient's preferred communication framework.

Main Results:

• No universal preference was found: 37.9% preferred BC/WC, 36.2% preferred R/B, and 25.9% had no preference.
• The BC/WC framework was associated with higher ratings for perceived surgeon listening and trustworthiness.
• A preference for the BC/WC framework was inversely associated with higher trust in the medical profession.

Conclusions:

• The best case/worst case (BC/WC) framework is a viable communication tool in palliative surgery, comparable to the traditional risk/benefit (R/B) approach.
• While not universally preferred, BC/WC enhances perceived surgeon communication qualities.
• Surgeons should consider tailoring communication strategies, potentially using BC/WC, to individual patient needs in complex discussions.