Chest
Opinions/HypothesesDifferences of Opinion: A Survey of Knowledge and Bias Among Clinicians Regarding the Role of Chemotherapy in Metastatic Non-small Cell Lung Cancer
Section snippets
Participants and Questionnaire Tool
A 16-question, multiple-choice questionnaire (see “Appendix”) was sent to all Australian consultant general internists (physicians), pulmonary and palliative care physicians, medical and radiation oncologists, and thoracic surgeons. Eligible clinicians were identified by the databases of the Internal Medicine Society of Australia and New Zealand, the Thoracic Society of Australia and New Zealand, the Australasian Chapter of Palliative Medicine of The Royal Australasian College of Physicians,
Results
A total of 1,325 questionnaires were sent. Of the 679 replies received (51%), 544 respondents (41%) were assessable. Demographics are detailed in Table 2.
Overall, 325 of the 544 respondents (60%) were deemed to have good knowledge regarding survival and response rate data for patients with metastatic NSCLC (Table 3). Paired comparisons showed more medical oncologists had good knowledge (76%) compared with thoracic surgeons (35%, p < 0.0001), general internists (50%, p = 0.0001) or pulmonary
Discussion
There were significant differences of beliefs regarding the role of chemotherapy in metastatic NSCLC between the various specialty groups. Significant heterogeneity between specialist groups suggests that level 1 evidence supporting the use of PBC regimens in patients with metastatic NSCLC who have an ECOG PS ≤ 1 to improve survival and quality of life (QOL)234 has not been accepted or understood by all specialists involved in the treatment of NSCLC.
Knowledge scores were higher among medical
Conclusion
This survey is the first study to specifically assess clinician beliefs regarding the role of chemotherapy for metastatic NSCLC. It demonstrates that 40% of these clinicians (including 24% of medical oncologists) do not have a good knowledge of survival and response rates to chemotherapy, despite consistency of such results in published data over the past decade. There remains a significant degree of pessimism regarding the potential benefits of chemotherapy, particularly among pulmonary
ACKNOWLEDGMENT
We thank Associate Professor Richard Fisher for statistical advice, and Mrs. Margaret Hardingham for clerical assistance.
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Understanding Racial Disparities in Cancer Treatment and Outcomes
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