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How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments.

Publication ,  Journal Article
Kozminski, MA; Neumann, PJ; Nadler, ES; Jankovic, A; Ubel, PA
Published in: Medical decision making : an international journal of the Society for Medical Decision Making
May 2011

To determine how oncologists value quality-enhancing v. life-prolonging outcomes attributable to chemotherapy.The authors surveyed a random sample of 1379 US medical oncologists (members of the American Society of Clinical Oncology), presenting them with 2 scenarios involving a hypothetical new chemotherapy drug. Given their responses, the authors derived the implicit cost-effectiveness ratios each physician attributed to quality-enhancing and life-prolonging chemotherapies.The authors received responses from 58% of the oncologists surveyed. On average, the responses implied that oncologists were willing to prescribe treatments that cost $245,972 per quality-adjusted life-year (QALY; SD $243,663 per QALY) in life-prolonging situations v. only $119,082 per QALY (SD $197,048 per QALY) for treatments that improve quality of life but do not prolong survival (P < 0.001). This difference did not depend on age, gender, percentage of time in clinical work, or self-reported preparedness to use and interpret cost-effectiveness information (P > 0.05 for all specifications). Differences across these situations persisted even among those who considered themselves to be "well-prepared" to make cost-effectiveness decisions.Cost-effectiveness thresholds for oncologists vary widely for life-prolonging chemotherapy compared to treatments that only enhance quality of life. This difference suggests that oncologists value length of survival more highly than quality of life when making chemotherapy decisions.

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Published In

Medical decision making : an international journal of the Society for Medical Decision Making

DOI

EISSN

1552-681X

ISSN

0272-989X

Publication Date

May 2011

Volume

31

Issue

3

Start / End Page

380 / 385

Related Subject Headings

  • Value of Life
  • United States
  • Time Factors
  • Quality-Adjusted Life Years
  • Prognosis
  • Physicians
  • Neoplasms
  • Middle Aged
  • Medical Oncology
  • Male
 

Citation

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Kozminski, M. A., Neumann, P. J., Nadler, E. S., Jankovic, A., & Ubel, P. A. (2011). How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments. Medical Decision Making : An International Journal of the Society for Medical Decision Making, 31(3), 380–385. https://doi.org/10.1177/0272989x10385847
Kozminski, Michael A., Peter J. Neumann, Eric S. Nadler, Aleksandra Jankovic, and Peter A. Ubel. “How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments.Medical Decision Making : An International Journal of the Society for Medical Decision Making 31, no. 3 (May 2011): 380–85. https://doi.org/10.1177/0272989x10385847.
Kozminski MA, Neumann PJ, Nadler ES, Jankovic A, Ubel PA. How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments. Medical decision making : an international journal of the Society for Medical Decision Making. 2011 May;31(3):380–5.
Kozminski, Michael A., et al. “How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments.Medical Decision Making : An International Journal of the Society for Medical Decision Making, vol. 31, no. 3, May 2011, pp. 380–85. Epmc, doi:10.1177/0272989x10385847.
Kozminski MA, Neumann PJ, Nadler ES, Jankovic A, Ubel PA. How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments. Medical decision making : an international journal of the Society for Medical Decision Making. 2011 May;31(3):380–385.
Journal cover image

Published In

Medical decision making : an international journal of the Society for Medical Decision Making

DOI

EISSN

1552-681X

ISSN

0272-989X

Publication Date

May 2011

Volume

31

Issue

3

Start / End Page

380 / 385

Related Subject Headings

  • Value of Life
  • United States
  • Time Factors
  • Quality-Adjusted Life Years
  • Prognosis
  • Physicians
  • Neoplasms
  • Middle Aged
  • Medical Oncology
  • Male