onr:"swepub:oai:gup.ub.gu.se/309039"
Search: onr:"swepub:oai:gup.ub.gu.se/309039" > Bridging the age ga...
- 1 of 1
- Previous record
- Next record
- To hitlist
Bridging the age gap in breast cancer: cluster randomized trial of two decision support interventions for older women with operable breast cancer on quality of life, survival, decision quality, and treatment choices
- Wyld, L. (author)
- Reed, M. W. R. (author)
- Collins, K. (author)
- show more...
- Burton, M. (author)
- Lifford, K. (author)
- Edwards, A. (author)
- Ward, S. (author)
- Holmes, G. (author)
- Morgan, J. (author)
- Bradburn, M. (author)
- Walters, S. J. (author)
- Ring, A. (author)
- Robinson, T. G. (author)
- Martin, C. (author)
- Chater, T. (author)
- Pemberton, K. (author)
- Shrestha, A. (author)
- Nettleship, A. (author)
- Murray, C. (author)
- Brown, M. (author)
- Richards, P. (author)
- Cheung, K. L. (author)
- Todd, A. (author)
- Harder, H. (author)
- Brain, K. (author)
- Wright, J. (author)
- Simcock, R. (author)
- Armitage, F. (author)
- Bursnall, M. (author)
- Green, T. (author)
- Revell, D. (author)
- Gath, J. (author)
- Horgan, K. (author)
- Holcombe, C. (author)
- Winter, M. (author)
- Naik, J. (author)
- Parmeshwar, R. (author)
- Gosney, M. (author)
- Hatton, M. (author)
- Thompson, A. M. (author)
- show less...
- (creator_code:org_t)
- 2021-03-23
- 2021
- English.
- In: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 108:5, s. 499-510
- Journal article (peer-reviewed)
Abstract
Subject headings
Close
- BACKGROUND: Rates of surgery and adjuvant therapy for breast cancer vary widely between breast units. This may contribute to differences in survival. This cluster RCT evaluated the impact of decision support interventions (DESIs) for older women with breast cancer, to ascertain whether DESIs influenced quality of life, survival, decision quality, and treatment choice. METHODS: A multicentre cluster RCT compared the use of two DESIs against usual care in treatment decision-making in older women (aged at least ≥70 years) with breast cancer. Each DESI comprised an online algorithm, booklet, and brief decision aid to inform choices between surgery plus adjuvant endocrine therapy versus primary endocrine therapy, and adjuvant chemotherapy versus no chemotherapy. The primary outcome was quality of life. Secondary outcomes included decision quality measures, survival, and treatment choice. RESULTS: A total of 46 breast units were randomized (21 intervention, 25 usual care), recruiting 1339 women (670 intervention, 669 usual care). There was no significant difference in global quality of life at 6 months after the baseline assessment on intention-to-treat analysis (difference -0.20, 95 per cent confidence interval (C.I.) -2.69 to 2.29; P=0.900). In women offered a choice of primary endocrine therapy versus surgery plus endocrine therapy, knowledge about treatments was greater in the intervention arm (94 versus 74 per cent; P=0.003). Treatment choice was altered, with a primary endocrine therapy rate among women with oestrogen receptor-positive disease of 21.0 per cent in the intervention versus 15.4 per cent in usual-care sites (difference 5.5 (95 per cent C.I. 1.1 to 10.0) per cent; P=0.029). The chemotherapy rate was 10.3 per cent at intervention versus 14.8 per cent at usual-care sites (difference -4.5 (C.I. -8.0 to 0) per cent; P=0.013). Survival was similar in both arms. CONCLUSION: The use of DESIs in older women increases knowledge of breast cancer treatment options, facilitates shared decision-making, and alters treatment selection. Trial registration numbers: EudraCT 2015-004220-61 (https://eudract.ema.europa.eu/), ISRCTN46099296 (http://www.controlled-trials.com). © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
- The British journal of surgery (Search for host publication in LIBRIS)
To the university's database
- 1 of 1
- Previous record
- Next record
- To hitlist
Find more in SwePub
- By the author/editor
- Wyld, L.
- Reed, M. W. R.
- Collins, K.
- Burton, M.
- Lifford, K.
- Edwards, A.
- show more...
- Ward, S.
- Holmes, G.
- Morgan, J.
- Bradburn, M.
- Walters, S. J.
- Ring, A.
- Robinson, T. G.
- Martin, C.
- Chater, T.
- Pemberton, K.
- Shrestha, A.
- Nettleship, A.
- Murray, C.
- Brown, M.
- Richards, P.
- Cheung, K. L.
- Todd, A.
- Harder, H.
- Brain, K.
- Audisio, Riccard ...
- Wright, J.
- Simcock, R.
- Armitage, F.
- Bursnall, M.
- Green, T.
- Revell, D.
- Gath, J.
- Horgan, K.
- Holcombe, C.
- Winter, M.
- Naik, J.
- Parmeshwar, R.
- Gosney, M.
- Hatton, M.
- Thompson, A. M.
- show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
- MEDICAL AND HEAL ...
- and Clinical Medicin ...
- and Cancer and Oncol ...
-
- MEDICAL AND HEALTH SCIENCES
- MEDICAL AND HEAL ...
- and Clinical Medicin ...
- and Surgery
- Articles in the publication
- The British jour ...
- By the university
- University of Gothenburg
Search outside SwePub
- Extend your search to:
- Google Book Search
- Google Scholar
Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.
- Copyright © LIBRIS - National Library Systems
- LIBRIS.kb.se
