Discrepancies Between Patient and Physician Estimates for the Success of Stem Cell Transplantation

Abstract

Models for optimal shared (or informed) medical decision making encourage open discourse between patients and physicians regarding the pros and cons of treatment options.^1-4 However, whether patients actually emerge from these discussions with accurate expectations for the chosen therapy has rarely been studied. Hematopoietic stem cell transplantation (SCT) for hematologic diseases offers an ideal opportunity to study this question in a high-stakes setting since SCT offers the potential of life extension or cure, but at substantial risk of treatment-related death. We measured the expectations of 313 patients and their physicians prior to transplantation, then conducted follow-up longitudinally to compare expectations with actual outcomes.