Japanese hematologists' and oncologists' perceptions of patient preferences for shared decision-making

Shared decision-making (SDM) is a key component of patient-centered oncology care, yet little is known about how Japanese physicians perceive their patients' roles in treatment decisions for diffuse large B-cell lymphoma (DLBCL). This study aimed to assess physicians' assumptions about patient preferences regarding SDM and to identify factors associated with these perceptions.

An online survey was completed by 227 hematologists and oncologists in Japan who had managed at least one DLBCL case in the past year. Most physicians believed patients prefer collaborative decision-making: 34.4% selected joint decision-making, 31.7% patient-led after physician input, and 26.4% physician-led incorporating patient input. Few perceived patients as preferring full autonomy (7.5%), and none indicated fully physician-led decisions. Greater experience with refractory patients was linked to more physician-led perceptions (OR = 0.95 per patient, p = 0.0033). Female physicians more often endorsed patient-led preferences (OR = 0.39, p = 0.0436), while those aged ≥60 years favored physician-led models (OR = 2.33, p = 0.0454). University hospital affiliation showed a trend toward more patient-led perceptions (OR = 0.65, p = 0.087). Overall, Japanese physicians predominantly assumed patients prefer shared rather than extreme decision-making roles.