Limitations
lung cancer, tumor
LUNG CANCER, DISEASE, TUMOR
Another intervention group — “decision aid only”, i.e., patients working with the decision aid by themselves, without coaching — would be desirable. With regard to the low possibility of recruiting an additional 89 patients in the given time, the idea of a second intervention group was dismissed.In the treatment of advanced lung cancer, there is no choice between several equivalent, evidence-based treatment options. Rather, patients have access to one single more or less promising treatment option vs. early palliative care alone or best supportive care. Our decision aid can therefore not be classified as a “traditional” decision aid according to the standards of evidence-based medicine. Patients have to decide between tumor-centered or symptom-oriented therapy and perceive a lack of alternatives concerning their treatment. Palliative care is often seen as giving in to their disease and consequently not an option to be considered.Another limitation arises from the organizational context: When treatment decisions are, e.g., made by physicians in tumor boards, what is the relevance of patients’ preferences? It is of course still possible to make shared decisions, but are physicians and patients really open to that?