癌症患者对预后的预测与他们的治疗偏好之间的关系
J C Weeks1, E F Cook, S J O'Day
1Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA 02115-6084, USA. janevweeks@dci.harvard.edu
JAMA
|June 12, 1998
概括
绝症癌症患者经常高估他们的生存率,影响治疗选择. 准确的预后理解与偏爱舒适护理而不是延长生命的疗法有关.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗决策的制定 医疗决策的制定
背景情况:
- 癌症患者经常高估他们的长期生存概率.
- 不准确的预后感知可能导致与患者价值观不一致的治疗选择.
- 这项研究调查了癌症终末期患者的准确预后和治疗偏好之间的联系.
研究的目的:
- 为了测试是否准确的预后理解与对终末期癌症患者的舒适性治疗相比延长生命治疗的偏好相关.
主要方法:
- 一项前性队列研究,涉及917名患有III/IV期转移性非小细胞肺癌或结肠癌的成年患者.
- 来自美国五家教学医院的数据.
- 患者/医生的生存预估与实际的6个月生存率进行了比较,并评估了延长生命与舒适护理的偏好.
主要成果:
- 过度估计6个月生存期的患者更有可能接受延长寿命的治疗 (OR 2.6).
- 当患者的生存估计非常高 (>90%) 和医生的估计非常低 (<=10%) 时,这种偏好最明显.
- 医生准确地估计了预后,而患者始终高估了他们的生存机会.
结论:
- 患有转移性肺癌和结肠癌的患者高估了生存概率.
- 这些膨胀的生存率估计显著影响患者对医疗疗法的偏好.
- 偏好延长生命治疗,由高估驱动,并没有改善实际的6个月存活率.
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