Table 4.
Percentage of Oncologists’ Recommending Chemotherapy for each Vignette Patient*
| Patient Vignette The patient (initials) is a ______year old female with a history of well-controlled hypertension, hyperlipidemia and osteoarthritis, who is referred for evaluation of metastatic pancreatic cancer. She has a 3 cm pancreatic adenocarcinoma with metastatic disease to the liver. Based upon her cancer diagnosis, her estimated life expectancy is six months or less. She currently reports moderate fatigue which is impacting her daily activities (ECOG PS =1) but denies any other symptoms from her cancer. She currently lives alone. | ||||
|---|---|---|---|---|
| Vignette Number (N=303)# | Varied Factors | Explanation of Varied Factors | % of Oncologists Recommending Chemotherapy^ | |
| Vignette 1 (n=34) | AM is a 72 year old female. She independently performs all activities of daily living and instrumental activities of daily living. She denies any memory problems or history of dementia. | -Younger -No functional impairment -No cognitive impairment |
97% | Multi-agent: 63% Monotherapy: 38% |
| Vignette 2 (n=39) | BL is a 72 year old female. She independently performs all activities of daily living but requires assistance with some instrumental activities of daily living including housekeeping and grocery shopping. She has had 3 falls in the past 6 months, and sustained an injury requiring an emergency room visit during one episode. She denies any memory problems or history of dementia. | -Younger -Functional impairment -No cognitive impairment |
74% | Multi-agent: 41% Monotherapy: 59% |
| Vignette 3 (n=31) | CK is a 72 year old female. She independently performs all activities of daily living and most instrumental activities of daily living. She requires assistance with managing household finances due to memory problems. Cognitive testing is performed and her cognition is found to be impaired (MMSE 15)**. | -Younger -No functional impairment -Cognitive impairment |
61% | Multi-agent: 39% Monotherapy: 61% |
| Vignette 4 (n=27) | DJ is a 72 year old female. She independently performs all activities of daily living but requires assistance with some instrumental activities of daily living including housekeeping, grocery shopping, and managing finances. She has had 3 falls in the past 6 months, and sustained an injury requiring an emergency room visit during one episode. Cognitive testing is performed and her cognition is found to be impaired (MMSE 15)**. | -Younger -Functional impairment -Cognitive impairment |
56% | Multi-agent: 13% Monotherapy: 87% |
| Vignette 5 (n=39) | EK is an 84 year old female. She independently performs all activities of daily living and instrumental activities of daily living. She denies any memory problems or history of dementia. | -Older -No functional impairment -No cognitive impairment |
85% | Multi-agent: 38% Monotherapy: 62% |
| Vignette 6 (n=41) | FH is an 84 year old female. She independently performs all activities of daily living, but requires assistance with some instrumental activities of daily living including housekeeping and grocery shopping. She has had 3 falls in the past 6 months, and sustained an injury requiring an emergency room visit during one episode. She denies any memory problems or history of dementia. | -Older -Functional impairment -No cognitive impairment |
44% | Multi-agent: 18% Monotherapy: 82% |
| Vignette 7 (n=43) | GS is an 84 year old female. She independently performs all activities of daily living and most instrumental activities of daily living. She only requires assistance with managing household finances due to memory problems. Cognitive testing is performed and her cognition is found to be impaired (MMSE 15)**. | -Older -No Functional impairment -Cognitive impairment |
37% | Multi-agent: 19% Monotherapy: 81% |
| Vignette 8 (n=49) | HT is an 84 year old female. She independently performs activities of daily living but requires assistance with some instrumental activities of daily living including housekeeping, grocery shopping and managing finances. She has had 3 falls in the past 6 months, and sustained an injury requiring an emergency room visit during one episode. Cognitive testing is performed and her cognition is found to be impaired (MMSE 15)**. | -Older -Functional impairment -Cognitive impairment |
14% | Multi-agent: 0% Monotherapy: 100% |
Bolded item are characteristics that were varied systematically between vignettes.
*
Each physician was randomized to one vignette as part of the survey; two physicians did not provide a response
^
Doublet vs monotherapy answer may not add to 100% due to missing data
**
A Mini-Mental State Exam Score (MMSE) of 15 is indicative of problems with learning new information, recognizing close relatives, personality changes, and behavior disorders.