Results Summary and Professional Abstract
|Article Highlight: Age-related challenges—including memory loss, limited caregiver availability, or chronic conditions—can affect how older adults respond to treatment for cancer, but physicians sometimes aren’t aware of them. This study wanted to see if a report about issues related to a patient’s age would improve care-planning communication among the patient, caregiver, and doctor. As reported in JAMA Oncology, compared with patients without a report, patients who had one were engaged in and more satisfied with conversations with their physician.|
|This project's final research report is expected to be available by August 2020.|
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers observed a few discrepancies between the abstract and other parts of the report regarding the primary and secondary aims as well as the outcome measures. They asked for the use of more consistent language in describing outcomes. The researchers revised the report as requested, especially the abstract, and specifically in describing caregiver use of the Health Care Climate Questionnaire (HCCQ). The researchers also added mention of nonsignificant findings about patient and caregiver health-related quality of life to the abstract to make sure that the abstract included all outcomes.
- The reviewers noted that the researchers used outcome data from the 4- to 6- week visit HCCQ when the 10- to 14-day post-visit data were not available. They asked the researchers how often this occurred and what the potential impact could be on the results. The researchers explained that they used the 4- to 6-week visit data in place of missing 10- to 14-day data in 60 patients. The researchers then looked at the outcomes trends for patients who completed both data points and found that the HCCQ values for age-related conversations decreased from the 10- to 14-day measurement to the 4- to 6-week measurement, indicating that the imputed values for those 60 patients should have been slightly lower than would have been expected if 10- to 14-day data were available. This led the researchers to conclude that their imputed results for 10- to 14-day outcomes should be considered conservative.
- The reviewers noted that once researchers added six-month outcome data to the longitudinal models, it was evident that the group differences in caregiver satisfaction with communication visible at four to six weeks was no longer visible at six months. The reviewers asked the researchers to change their conclusions accordingly. The researchers countered that because the intervention did show improvement in caregiver satisfaction at 4-6 weeks, it was reasonable to conclude that the intervention performed better than the control group on this measure. They did revise their conclusions to acknowledge that the benefits evident at four to six weeks did not persist to six months.
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