Independent validation of time to treatment as a prognostic factor in uveal melanoma

Cancer research · Melanoma

The study assessed the frequency of non‑neutral framing by ocular oncologists in consultations with patients newly diagnosed with uveal melanoma and found that 84% of consultations contained non‑neutral framing, though this was not related to patient satisfaction with decision‑making.

Background A subset of uveal melanomas can be treated using either enucleation or proton beam therapy (PBT), which offer similar oncological outcomes. The most appropriate treatment depends on a patient’s preference. To allow patients to genuinely determine their preference, it is recommended to describe options as neutrally as possible. This study assesses to what extent ocular oncologists use and perceive non‑neutral framing behaviour, and if it is related to patient satisfaction with decision‑making. Methods Consultations of ocular oncologists with patients newly diagnosed with uveal melanoma were audio recorded, transcribed verbatim, and coded for ocular oncologists’ explicit and implicit non‑neutral framing behaviours. Explicit non‑neutral framing was defined as: explicitly mentioning a preferred option at least once, without relating it to the patient. Implicit non‑neutral framing was defined as: describing an option (un)favourably, without providing a medically substantive clarification alongside. Results 110 patients provided consent for the audio recordings. Non‑neutral framing was found in 84% (n=92/110) of consultations. We found explicit behaviour in 38% (42/110) and implicit behaviour in 76% (84/110, median=1, range, 0‑4) of consultations. The most frequent implicit framing was presenting options by positively or negatively emphasizing one option. Non‑neutral framing behaviours were not significantly related to patient satisfaction with decision‑making. Conclusion This study shows that in most consultations some non‑neutral framing was present, which did not impact patients’ satisfaction with decision‑making. Nonetheless, ocular oncologists should be aware that how they describe options may influence preferences in ways that do not align with the patient’s values.

The results suggest that even when medical professionals present therapeutic options non‑neutrally, patients’ satisfaction with the decision‑making process may remain unaffected. However, awareness of potential framing effects is important to ensure that patient preferences are truly aligned with their values.

Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.

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