Differences between pulmonologists, thoracic surgeons and radiation oncologists in deciding on the treatment of stage I XXXX : A binary choice experiment.

@entity1 @entity1149 @entity1030
BACKGROUND AND PURPOSE: Surgery is the standard of care in stage I @entity1149 ( @entity1149 ), but stereotactic ablative radiotherapy (SABR) is increasingly used to treat @entity1 at high-risk for surgical complications. We studied which @entity1 - and clinician-related characteristics influenced treatment recommendations. MATERIAL AND METHODS: A binary choice experiment with hypothetical cases was conducted. Cases varied on five @entity1 -related characteristics: @entity1 age, @entity1030 Global Initiative for @entity1030 ( @entity1030 ) score, Charlson co-morbidity index, World Health Organization performance status (WHO-PS) and @entity1 treatment preference (surgery/SABR). Clinician characteristics were recorded. Responses were analyzed using generalized linear mixed models. RESULTS: 126 clinicians completed the survey. All @entity1 -related characteristics, the clinician speciality, and whether clinicians considered outcomes of surgery comparable to SABR, significantly influenced treatment recommendations. Pulmonologists were most influenced by WHO-PS and comorbidity, whereas comorbidity and age had greatest influence on radiation oncologists and surgeons. Clinicians were less influenced by stated @entity1 preference and @entity1030 score. Limited consistency was observed in treatment recommendations. CONCLUSIONS: This study suggests that more efforts are needed to develop uniform approaches for making treatment recommendations, and also to incorporate @entity1 preferences when making treatment decisions for stage I @entity1149 .
