Cargando…
Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology
(1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778253/ https://www.ncbi.nlm.nih.gov/pubmed/35055337 http://dx.doi.org/10.3390/jpm12010022 |
_version_ | 1784637274220134400 |
---|---|
author | Pollard, Samantha Dunne, Jessica Costa, Sarah Regier, Dean A. |
author_facet | Pollard, Samantha Dunne, Jessica Costa, Sarah Regier, Dean A. |
author_sort | Pollard, Samantha |
collection | PubMed |
description | (1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers to precision oncology implementation from the perspectives of health system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with health technology decision makers (n = 14) and clinicians (n = 18) experienced with precision oncology. Participants were recruited using a purposive sampling technique. Interviews were analyzed using thematic analysis. Recruitment continued until two qualitative analysts reached agreement that thematic saturation was reached. (3) Results: While cautiously optimistic about the potential for enhanced therapeutic alignment, participants identified multiple decisional challenges under conditions of evidentiary uncertainty. Decision makers voiced concern over resource requirements alongside small benefitting patient populations and limited evidence supporting patient and health system impacts. Clinicians were comparatively tolerant of evidentiary uncertainty guiding clinical decision-making practices. Clinicians applied a broader definition of patient benefit, focusing on the ability to assist patients making informed clinical decisions. (4) Conclusions: Sustainable precision oncology must balance demand with evidence demonstrating benefit. We show that clinicians and decision makers vary in their tolerance for evolving knowledge, suggesting a need to establish evidentiary standards supporting precision oncology reimbursement decisions. |
format | Online Article Text |
id | pubmed-8778253 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87782532022-01-22 Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology Pollard, Samantha Dunne, Jessica Costa, Sarah Regier, Dean A. J Pers Med Article (1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers to precision oncology implementation from the perspectives of health system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with health technology decision makers (n = 14) and clinicians (n = 18) experienced with precision oncology. Participants were recruited using a purposive sampling technique. Interviews were analyzed using thematic analysis. Recruitment continued until two qualitative analysts reached agreement that thematic saturation was reached. (3) Results: While cautiously optimistic about the potential for enhanced therapeutic alignment, participants identified multiple decisional challenges under conditions of evidentiary uncertainty. Decision makers voiced concern over resource requirements alongside small benefitting patient populations and limited evidence supporting patient and health system impacts. Clinicians were comparatively tolerant of evidentiary uncertainty guiding clinical decision-making practices. Clinicians applied a broader definition of patient benefit, focusing on the ability to assist patients making informed clinical decisions. (4) Conclusions: Sustainable precision oncology must balance demand with evidence demonstrating benefit. We show that clinicians and decision makers vary in their tolerance for evolving knowledge, suggesting a need to establish evidentiary standards supporting precision oncology reimbursement decisions. MDPI 2022-01-01 /pmc/articles/PMC8778253/ /pubmed/35055337 http://dx.doi.org/10.3390/jpm12010022 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Pollard, Samantha Dunne, Jessica Costa, Sarah Regier, Dean A. Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title | Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title_full | Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title_fullStr | Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title_full_unstemmed | Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title_short | Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology |
title_sort | stakeholder perspectives on navigating evidentiary and decision uncertainty in precision oncology |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778253/ https://www.ncbi.nlm.nih.gov/pubmed/35055337 http://dx.doi.org/10.3390/jpm12010022 |
work_keys_str_mv | AT pollardsamantha stakeholderperspectivesonnavigatingevidentiaryanddecisionuncertaintyinprecisiononcology AT dunnejessica stakeholderperspectivesonnavigatingevidentiaryanddecisionuncertaintyinprecisiononcology AT costasarah stakeholderperspectivesonnavigatingevidentiaryanddecisionuncertaintyinprecisiononcology AT regierdeana stakeholderperspectivesonnavigatingevidentiaryanddecisionuncertaintyinprecisiononcology |