MedicalResearch.com Interview with:
Dr. Yvonne Bombard, PhD
Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital
Assistant Professor, Institute of Health Policy, Management and Evaluation,
Faculty of Medicine, University of Toronto
MedicalResearch.com: What are the main findings of the study?
Dr. Bombard: The main finding of the study is that gene expression profiling tests play a critical role when women with early-stage breast cancer decide whether to have chemotherapy, but many of them do not fully understand what some of the test results mean. For many the gene expression profiling test was the main factor in their treatment decision.
The women we interviewed understood the test would indicate whether chemotherapy would be beneficial to them. But many thought the test reflected their unique circumstances and did not understand that their test result was based on larger population statistics. Patients often viewed their gene expression profiling results as providing information that was more scientifically valid, uniquely personalized and emotionally significant than any other information they had received. For many, the test was a transformational element that empowered them, allowed them to feel confident in their decisions and may even have rescued them from unnecessary chemotherapy.
Patients described emotionally and socially complex reasons why they valued gene expression profiling testing in making their treatment decisions. Patients valued the test because it provided them with certainty amidst confusion, with options and a sense of empowerment, and with personalized, authoritative information.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Bombard: The extent to which gene expression profiling results were valued and determined patients’ treatment decisions were unexpected, as were the misunderstandings they had of the results. Many thought the test reflected their unique circumstances and did not understand that their test result was based on larger population statistics. They also believed that gene expression profiling testing had unique scientific power and, therefore, truth-value. Taken together, this illuminates an important paradox: patients tend to overestimate the truth-value of gene expression profiling testing based on misperceptions of its validity.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Bombard: Patients tend to overestimate the truth-value of gene expression profiling testing based on misperceptions of its validity. Our results identify a need to better support patient understanding of the test and its limitations. Our results might also help to support provider awareness of the ways in which patients can be emotionally invested in their GEP results and the impact of those investments on treatment decisions.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Bombard: Our results identify a need to better support patient understanding of the test and its limitations. This may be achieved through decision or communication aids, for which further development and evaluation is warranted.
Breast cancer patients place huge emphasis on gene expression profiling test when making chemotherapy decisions, but many do not fully understand test
1. Y. Bombard, L. Rozmovits, M.E. Trudeau, N.B. Leighl, K. Deal, D.A. Marshall. Patients’ perceptions of gene expression profiling in breast cancer treatment decisions. Current Oncology, 2014; 21 (2): 203 DOI: 10.3747/co.21.1524