Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, Birmingham, Alabama.
Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, Alabama.
Psychooncology. 2020 Feb;29(2):406-412. doi: 10.1002/pon.5277. Epub 2019 Nov 12.
To determine if cognition can be used to identify persons with cancer at high risk for the impaired ability to understand treatment decisions.
The association between understanding treatment decisions and cognition was examined using data from 181 participants across four groups: 67 with brain metastasis, 41 with metastatic cancer that has not spread to the brain, 27 with malignant glioma, and 46 healthy controls. All diagnoses were made by board-certified oncologists and were verified histologically.
Results indicated that numerous cognitive functions were associated with the ability to understand treatment decisions in persons with cancer. The following proportion of participants demonstrated impaired understanding of treatment decisions in our three patient groups: approximately 51% malignant glioma, approximately 46% brain metastasis, and approximately 24% metastatic cancer. In a combined brain cancer group, we were able to use cognitive performance to predict the impaired ability to understand treatment decisions.
An impaired ability to understand treatment decisions is prevalent in persons with brain cancer and persons with metastatic cancer. Performance on a brief cognitive battery can be used to help clinicians identify patients at particular risk for impaired medical decision making.
确定认知能力是否可用于识别患有癌症且有能力理解治疗决策受损风险的患者。
使用来自四个组别的 181 名参与者的数据，研究了理解治疗决策与认知之间的关联：67 名患有脑转移的患者，41 名患有未扩散至大脑的转移性癌症的患者，27 名患有恶性胶质瘤的患者和 46 名健康对照组。所有诊断均由经过董事会认证的肿瘤学家做出，并通过组织学得到验证。
结果表明，许多认知功能与癌症患者理解治疗决策的能力有关。我们的三组患者中有以下比例的患者表现出对治疗决策理解的受损：约 51％的恶性胶质瘤，约 46％的脑转移，以及约 24％的转移性癌症。在合并的脑癌组中，我们能够使用认知表现来预测理解治疗决策的受损能力。
在患有脑癌和转移性癌症的患者中，理解治疗决策的能力受损是普遍存在的。简短的认知能力测试可以帮助临床医生识别出有特定风险的患者，这些患者在医疗决策方面可能存在受损。
