Physician uncertainty aversion impacts medical decision making for older patients with acute myeloid leukemia: results of a national survey

Haematologica
Pierre BoriesAntoine Nebout

Abstract

Elderly patients with acute myeloid leukemia can be treated with intensive chemotherapy, low-intensity therapy such as low-dose aracytine or hypomethylating agents, or best supportive care. The choice between these treatments is a function of many patient-related and disease-related factors. We investigated how physicians' behavioral characteristics affect medical decision-making between intensive and non-intensive therapy in this setting. A nationwide cross-sectional online survey of hematologists collected data on medical decision-making for 6 clinical vignettes involving older acute myeloid leukemia patients that were representative of routine practice. Questionnaires elicited physicians' demographic and occupational characteristics along with their individual behavioral characteristics according to a decision theory framework. From the pattern of responses to the vignettes, a K-means clustering algorithm was used to distinguish those who were likely to prescribe more intensive therapy and those who were likely to prescribe less intensive or no therapy. Multivariate analyses were used to identify physician's characteristics predictive of medical decision-making. We obtained 230 assessable answers, which represented an adjust...Continue Reading

Citations

Dec 4, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael LübbertUNKNOWN DECIDER Study Team
Aug 25, 2020·American Journal of Hematology·Elihu H Estey
Jan 29, 2021·Blood·Roni Shouval, Robert J Soiffer
Mar 30, 2021·Journal of Internal Medicine·V Lj Lazarevic
Dec 11, 2021·Expert Opinion on Pharmacotherapy·Monia MarchettiManuela Canicattì

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