Patients' Values and Clinical Substituted Judgments: The Case of Localized Prostate Cancer

The authors examined agreement between patients' utilities and importance rankings and clinicians' judgments of these assessments using a multiattribute model representing 6 aspects of health states potentially associated with localized prostate cancer. Patients were interviewed individual...

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Bibliographic Details
Published in:Health psychology 2005-07, Vol.24 (4S), p.S85-S92
Main Authors: Elstein, Arthur S, Chapman, Gretchen B, Knight, Sara J
Format: Article
Language:English
Subjects:
Cancer
Client Attitudes
Clinical information
Clinical Judgment (Not Diagnosis)
Decision Making
Doctor-Patient communication
Health
Human
Humans
Judgments
Male
Medical treatment
Models, Theoretical
Neoplasms
Patient Participation - psychology
Patients
Physician-Patient Relations
Preferences
Prostate
Prostatic cancer
Prostatic Neoplasms - therapy
Quality of Life
Substitution strategies
Time tradeoff technique
United States
Urogenital Disorders
Utility analysis
Values
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Summary:The authors examined agreement between patients' utilities and importance rankings and clinicians' judgments of these assessments using a multiattribute model representing 6 aspects of health states potentially associated with localized prostate cancer. Patients were interviewed individually shortly after diagnosis and at a follow-up visit to obtain time-tradeoff utilities for 4 health states, including current health, and importance ranks of the 6 attributes. Their clinicians independently provided views of what utilities and importance ranks would be in the patient's best interest. Using patient-clinician pairs as the unit of analysis, the authors discovered that only about 50% of the correlations across 4 health states were high enough (.80) to be acceptable for clinical use for substituted judgment. Their conclusion: Clinicians should recognize that their judgments of the utility of health states associated with localized prostate cancer may not correspond closely with those of the patient.
ISSN:0278-6133
1930-7810
DOI:10.1037/0278-6133.24.4.S85