Preferences of patients and oncologists for advanced ovarian cancer treatment-related health States

Purpose: The purpose of this study was to compare expected utility preferences of various health outcomes of chemotherapy treatment among ovarian-cancer patients receiving chemotherapy, ovarian cancer patients who were post-treatment (eg, under surveillance), and oncologists who treat this disease. Methods: Participants were asked to score 6 hypothetical ovarian cancer treatment-related health states using both a rating scale and the standard gamble. Scores were obtained in the range of 0.0 (death) to 1.0 (perfect health) for each hypothetical health state, with a difference of 0.10 being practically meaningful, and were analyzed by analysis of variance. Results: Seventy-five eligible participants were included in this study (41 ovarian-cancer patients and 34 oncologists). Patients and physicians reported similar responses in the rating scale exercise (F = 0.854, P = .43). However, when the health states were presented with an element of uncertainty via the standard gamble exercise, patients who were under surveillance reported significantly different expected utilities of the health states from physicians and from patients who were receiving treatment, demonstrating greater risk aversion than the other groups (F = 4.270, P = .018). Conclusions: This study suggests that there are significant differences in expected utility preferences among patients who are under surveillance as opposed to oncologists or patients receiving treatment, despite similarities in rating scale values. These findings suggest a need to further evaluate these differences in expected utility preferences in the context of decision in the setting of recurrent disease, where a patient under surveillance must make decisions related to re-initiation of therapy at a time when her preferences are likely to significantly differ from those of oncologists.