The impact of physician’s characteristics on decision-making in head and neck oncology: Results of a national survey

L’impact des caractéristiques des médecins sur la prise de décision en oncologie de la tête et du cou: Résultats d’une enquête nationale

Emilien Chabrillac, Sébastien Lamy, Pascale Grosclaude, Fanny Cros, Benjamin Vairel, Jérôme Sarini, Sébastien Vergez (), Antoine Nebout (), Pierre Bories and Agnès Dupret-Bories
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Emilien Chabrillac: IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Sébastien Lamy: ICR - Institut Claudius Regaud, Equipe EQUITY (CERPOP) - CERPOP - Centre d'Epidémiologie et de Recherche en santé des POPulations - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Pascale Grosclaude: ICR - Institut Claudius Regaud, Equipe EQUITY (CERPOP) - CERPOP - Centre d'Epidémiologie et de Recherche en santé des POPulations - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Fanny Cros: Service Oto-Rhino-Laryngologie (ORL) et chirurgie cervico-faciale [CHU Toulouse] - Pôle Clinique des Voies respiratoires [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
Benjamin Vairel: IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Jérôme Sarini: IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Sébastien Vergez: IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale, Service Oto-Rhino-Laryngologie (ORL) et chirurgie cervico-faciale [CHU Toulouse] - Pôle Clinique des Voies respiratoires [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
Antoine Nebout: UMR PSAE - Paris-Saclay Applied Economics - AgroParisTech - Université Paris-Saclay - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Pierre Bories: ICR - Institut Claudius Regaud
Agnès Dupret-Bories: IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale

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Abstract: Objectives: The aim of this study was to identify the socio-professional and behavioral factors influencing decision-making between surgical and non-surgical treatment in Upper AeroDigestive Tract (UADT) oncology among surgeons and oncologists.Materials and methods: We conducted a nationwide online survey among surgeons and medical or radiation oncologists treating head and neck cancer patients in France. The questionnaire collected physicians' demographics, type of practice, individual behavioral characteristics (attitudes toward risk and uncertainty) and data on decision-making via clinical case scenarios.Results: In total, 197 questionnaires were usable. Clinical case scenarios were grouped into three categories according to the prognostic and functional impact of the choice between surgical or non-surgical treatment. For clinical case scenarios where evidence-based medicine considered surgery as the best option, surgeons were significantly more likely to offer surgery in multivariable analysis. When surgery and non-surgical treatment were equivalent, multivariable analysis showed that the tendency to offer surgery increased with the physician's age, and decreased as the number of patients treated per year increased. When non-surgical treatment was the best option because of very high surgical morbidity, multivariable analysis showed a higher propensity to opt for surgery for the age group 40 - 59 versus 25 - 39, and a lower likelihood of choosing surgery among oncologists.Conclusion: This study sheds light on the physicians' socio-professional and behavioral factors influencing decision-making in UADT oncology. These mechanisms, poorly studied and probably underestimated, partly explain the variability of the decisions taken when confronted with clinical situations that are subject to debate.

Keywords: Head and neck cancer; Multidisciplinary tumor board; Practice variations; Behavioral factors; Socio-professional factors; Decision under risk and uncertainty (search for similar items in EconPapers)
Date: 2022-06
Note: View the original document on HAL open archive server: https://hal.inrae.fr/hal-04083656v1
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Published in Oral Oncology, 2022, 129, pp.105895. ⟨10.1016/j.oraloncology.2022.105895⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04083656

DOI: 10.1016/j.oraloncology.2022.105895

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