Use of Persuasive Language in Communication of Risk during Prostate Cancer Treatment Consultations

Aurash Naser-Tavakolian, Rebecca Gale, Michael Luu, John M. Masterson, Abhishek Venkataramana, Dmitry Khodyakov, Jennifer T. Anger, Edwin Posadas, Howard Sandler, Stephen J. Freedland, Brennan Spiegel and Timothy J. Daskivich
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Aurash Naser-Tavakolian: Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Rebecca Gale: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA
Michael Luu: Department of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
John M. Masterson: Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Abhishek Venkataramana: Department of Urology, University of Southern California, Los Angeles, CA, USA
Dmitry Khodyakov: RAND Institute, Santa Monica, CA, USA
Jennifer T. Anger: Department of Urology, University of California, San Diego, San Diego, CA, USA
Edwin Posadas: Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Howard Sandler: Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Stephen J. Freedland: Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Brennan Spiegel: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA
Timothy J. Daskivich: Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA

Medical Decision Making, 2024, vol. 44, issue 3, 320-334

Abstract: Background Physician treatment preference may influence how risks are communicated in prostate cancer consultations. We identified persuasive language used when describing cancer prognosis, life expectancy, and side effects in relation to a physician’s recommendation for aggressive (surgery/radiation) or nonaggressive (active surveillance/watchful waiting) treatment. Methods A qualitative analysis was performed on transcribed treatment consultations of 40 men with low- and intermediate-risk prostate cancer across 10 multidisciplinary providers. Quotes pertaining to cancer prognosis, life expectancy, and side effects were randomized. Coders predicted physician treatment recommendations from isolated blinded quotes. Testing characteristics of consensus predictions against the physician’s treatment recommendation were reported. Coders then identified persuasive strategies favoring aggressive/nonaggressive treatment for each quote. Frequencies of persuasive strategies favoring aggressive/nonaggressive treatment were reported. Logistic regression quantified associations between persuasive strategies and physician treatment recommendations. Results A total of 496 quotes about cancer prognosis ( n  = 127), life expectancy ( n  = 51), and side effects ( n  = 318) were identified. The accuracy of predicting treatment recommendation based on individual quotes containing persuasive language ( n  = 256/496, 52%) was 91%. When favoring aggressive treatment, persuasive language downplayed side effect risks and amplified cancer risk (recurrence, progression, or mortality). Significant predictors ( P  

Keywords: shared decision making; risk communication; prostate cancer; qualitative analysis (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:44:y:2024:i:3:p:320-334

DOI: 10.1177/0272989X241228612

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