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An Exploration of Relative Health Stock in Advanced Cancer Patients

Johns Hopkins University, Baltimore, Maryland

Kevin P. Weinfurt, PhD

Duke University, Durham, North Carolina

Liana D. Castel, MSPH

Duke University, Durham, North Carolina

Venita DePuy, MS

Duke University, Durham, North Carolina

Yun Li, MS

Duke University, Durham, North Carolina

Andrew Balshem, BA

Fox Chase Cancer Center, Philadelphia, Pennsylvania

Al Benson, MD, FACP

Northwestern University, Chicago, Illinois

Caroline B. Burnett, ScD, RN

Georgetown University, Washington, DC

Sandra Corbett, MS

Fox Chase Cancer Center, Philadelphia, Pennsylvania

John Marshall, MD

Georgetown University, Washington, DC

Elyse Slater, MS

Fox Chase Cancer Center, Philadelphia, Pennsylvania

Daniel P. Sulmasy, MD

St. Vincent’s Manhattan and New York Medical College, New York, New York

David Van Echo, MD

University of Maryland, Baltimore

Neal J. Meropol, MD

Fox Chase Cancer Center, Philadelphia, Pennsylvania

Kevin A. Schulman, MD

Duke University, Durham, North Carolina

Objective. The authors sought to empirically test whether relative health stock, a measure of patients’ sense of loss in their health due to illness, influences the treatment decisions of patients facing life-threatening conditions. Specifically, they estimated the effect of relative health stock on advanced cancer patients’ decisions to participate in phase I clinical trials. Method. A multicenter study was conducted to survey 328 advanced cancer patients who were offered the opportunity to participate in phase I trials. The authors asked patients to estimate the probabilities of therapeutic benefits and toxicity, their relative health stock, risk preference, and the importance of quality of life. Results. Controlling for health-related quality of life, an increase in relative health stock by 10 percentage points reduced the odds of choosing to participate in a phase I trial by 16% (odds ratio = 0.84, 95% confidence interval = 0.72, 0.97). Conclusion. Relative health stock affects advanced cancer patients’ treatment decisions.

Key Words: patient preferences • decision making • clinical trials • cancer • phase I trials

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