What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment
Introduction Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with “significant comorbidity” or “reduced life expectancy” should be treated this way and age should not be a fact...
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| Format: | Article |
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Elsevier
2017
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| Online Access: | https://eprints.nottingham.ac.uk/40947/ |
| _version_ | 1848796168977383424 |
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| author | Morgan, J.L. Walters, S.J. Collins, K. Robinson, T.G. Cheung, Kwok-Leung Audisio, R. Reed, M.W. Wyld, L. |
| author_facet | Morgan, J.L. Walters, S.J. Collins, K. Robinson, T.G. Cheung, Kwok-Leung Audisio, R. Reed, M.W. Wyld, L. |
| author_sort | Morgan, J.L. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Introduction
Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with “significant comorbidity” or “reduced life expectancy” should be treated this way and age should not be a factor.
Methods
A Discrete Choice Experiment (DCE) was used to determine the impact of key variables (patient age, comorbidity, cognition, functional status, cancer stage, cancer biology) on healthcare professionals' (HCP) treatment preferences for operable breast cancer among older women. Multinomial logistic regression was used to identify associations.
Results
40% (258/641) of questionnaires were returned. Five variables (age, co-morbidity, cognition, functional status and cancer size) independently demonstrated a significant association with treatment preference (p < 0.05). Functional status was omitted from the multivariable model due to collinearity, with all other variables correlating with a preference for operative treatment over no preference (p < 0.05). Only co-morbidity, cognition and cancer size correlated with a preference for PET over no preference (p < 0.05).
Conclusion
The majority of respondents selected treatment in accordance with current guidelines, however in some scenarios, opinion was divided, and age did appear to be an independent factor that HCPs considered when making a treatment decision in this population. |
| first_indexed | 2025-11-14T19:43:42Z |
| format | Article |
| id | nottingham-40947 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:43:42Z |
| publishDate | 2017 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-409472020-05-04T19:56:40Z https://eprints.nottingham.ac.uk/40947/ What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment Morgan, J.L. Walters, S.J. Collins, K. Robinson, T.G. Cheung, Kwok-Leung Audisio, R. Reed, M.W. Wyld, L. Introduction Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with “significant comorbidity” or “reduced life expectancy” should be treated this way and age should not be a factor. Methods A Discrete Choice Experiment (DCE) was used to determine the impact of key variables (patient age, comorbidity, cognition, functional status, cancer stage, cancer biology) on healthcare professionals' (HCP) treatment preferences for operable breast cancer among older women. Multinomial logistic regression was used to identify associations. Results 40% (258/641) of questionnaires were returned. Five variables (age, co-morbidity, cognition, functional status and cancer size) independently demonstrated a significant association with treatment preference (p < 0.05). Functional status was omitted from the multivariable model due to collinearity, with all other variables correlating with a preference for operative treatment over no preference (p < 0.05). Only co-morbidity, cognition and cancer size correlated with a preference for PET over no preference (p < 0.05). Conclusion The majority of respondents selected treatment in accordance with current guidelines, however in some scenarios, opinion was divided, and age did appear to be an independent factor that HCPs considered when making a treatment decision in this population. Elsevier 2017-07 Article PeerReviewed Morgan, J.L., Walters, S.J., Collins, K., Robinson, T.G., Cheung, Kwok-Leung, Audisio, R., Reed, M.W. and Wyld, L. (2017) What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment. European Journal of Surgical Oncology (EJSO), 43 (7). pp. 1282-1287. ISSN 0748-7983 Breast cancer; Primary endocrine therapy; Surgery; Discrete choice experiment; Older http://www.sciencedirect.com/science/article/pii/S0748798317301075 doi:10.1016/j.ejso.2017.01.012 doi:10.1016/j.ejso.2017.01.012 |
| spellingShingle | Breast cancer; Primary endocrine therapy; Surgery; Discrete choice experiment; Older Morgan, J.L. Walters, S.J. Collins, K. Robinson, T.G. Cheung, Kwok-Leung Audisio, R. Reed, M.W. Wyld, L. What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title | What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title_full | What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title_fullStr | What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title_full_unstemmed | What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title_short | What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| title_sort | what influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment |
| topic | Breast cancer; Primary endocrine therapy; Surgery; Discrete choice experiment; Older |
| url | https://eprints.nottingham.ac.uk/40947/ https://eprints.nottingham.ac.uk/40947/ https://eprints.nottingham.ac.uk/40947/ |