Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
J Gynecol Oncol. 2024 Sep;35(5):e63. doi: 10.3802/jgo.2024.35.e63. Epub 2024 Mar 21.
Patients with advanced ovarian cancer face a range of treatment options, and there is unwarranted variation in treatment decision-making between UK providers. Decision support tools that produce data on treatment outcomes as a function of individual patient characteristics, would help both patients and clinicians to make informed, preference- and values-based choices. However, data on treatment outcomes to include in such tools are lacking.
Following a literature review, a questionnaire was designed for use in a Delphi process to establish which treatment outcomes are important to both patients and clinicians in decision-making for treatment for advanced ovarian cancer. Patient and clinician panels were established.
Following 2 Delphi rounds, consensus was achieved for 7/11 items in the patient panel and 8/11 items in the clinician panel. Consensus across both panels was achieved for inclusion of both overall survival and progression free survival as important items in the decision-making process, although there remained differences of opinion as to whether these should be presented as relative or absolute values.
Information needs for treatment decision-making in ovarian cancer differ between and within patient and clinician groups. Whilst overall survival and progression free survival are universally accepted as important data items, decision support tools will need to be nuanced to allow presentation of a range of outcomes and associated probabilities, and in a range of formats, that can be tailored to the preferences of clinician and patients.
晚期卵巢癌患者面临多种治疗选择，英国医疗服务提供者在治疗决策方面存在不必要的差异。能够根据患者个体特征生成治疗结果数据的决策支持工具，将有助于患者和临床医生做出基于信息、偏好和价值观的选择。然而，此类工具中缺乏治疗结果数据。
在文献回顾后，设计了一份问卷，用于德尔菲法，以确定哪些治疗结果对患者和临床医生在晚期卵巢癌治疗决策中具有重要意义。成立了患者小组和临床医生小组。
经过两轮德尔菲法，患者小组的 11 项中有 7 项、临床医生小组的 11 项中有 8 项达成共识。患者和临床医生小组均达成共识，将总生存期和无进展生存期纳入决策过程的重要项目，尽管对于这些项目应该以相对值还是绝对值呈现，仍存在不同意见。
卵巢癌治疗决策的信息需求在患者和临床医生群体之间和内部存在差异。虽然总生存期和无进展生存期被普遍认为是重要的数据项目，但决策支持工具需要更加细致，以允许呈现一系列结果及其相关概率，并以多种格式呈现，以满足临床医生和患者的偏好。
