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. 2024 Feb 14;24(1):36.
doi: 10.1007/s10238-023-01261-4.

Developing questions to assess and measure patients' perceived survival benefit from adjuvant endocrine therapy in breast cancer: a mixed methods pilot study

Bernard Tawfik  1   2 , Kendal Jacobson  3 , Ursa Brown-Glaberman  3   4 , Mikaela Kosich  3 , M Lee Van Horn  5 , Jacklyn Nemunaitis  3   4 , Zoneddy Dayao  3   4 , V Shane Pankratz  3   6 , Andrew L Sussman  3   7 , Dolores D Guest  3   6
Affiliations

Developing questions to assess and measure patients' perceived survival benefit from adjuvant endocrine therapy in breast cancer: a mixed methods pilot study

Bernard Tawfik et al. Clin Exp Med. .

Abstract

This mixed method study developed multiple question types to understand and measure women's perceived benefit from adjuvant endocrine therapy. We hypothesis that patients do not understand this benefit and sought to develop the questions needed to test this hypothesis and obtain initial patient estimates. From 8/2022 to 3/2023, qualitative interviews focused on assessing and modifying 9 initial varied question types asking about the overall survival (OS) benefit from adjuvant endocrine therapy. Subsequent focus groups modified and selected the optimal questions. Patients' self-assessment of their OS benefit was compared to their individualized PREDICT model results. Fifty-three patients completed the survey; 42% Hispanic, 30% rural, and 47% with income < $39,999 per year. Patients reported adequate health care literacy (61.5%) and average confidence about treatment and medication decisions 49.4 (95% CI 24.4-59.5). From the original 9 questions, 3 modified questions were ultimately found to capture patients' perception of this OS benefit, focusing on graphical and prose styles. Patients estimated an OS benefit of 42% compared to 4.4% calculated from the PREDICT model (p < 0.001). In this group with considerable representation from ethnic minority, rural and low-income patients, qualitative data showed that more than one modality of question type was needed to clearly capture patients' understanding of treatment benefit. Women with breast cancer significantly overestimated their 10-year OS benefit from adjuvant endocrine therapy compared to the PREDICT model.

Keywords: Adjuvant endocrine therapy; Breast cancer; Overall survival benefit; PREDICT model; Patient understanding.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Initial and final questions to measure OS benefit from adjuvant endocrine therapy
Fig. 1
Fig. 1
Initial and final questions to measure OS benefit from adjuvant endocrine therapy
Fig. 2
Fig. 2
Patient interview and consensus process
Fig. 3
Fig. 3
Results of PROMIS
Fig. 4
Fig. 4
Patients perceived vs. modeled OS benefit from adjuvant endocrine therapy
See this image and copyright information in PMC

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