A rose by any other name.

One nifty gauge of patient psyche is a discrete choice experiment. Here’s one where >1K young healthy subjects were asked to select their preferences from a range of hypothetical clinical scenarios surrounding a diagnosis of a thyroid cancer that could be safely observed. The probabilities that various details were selected were used to quantify the value of each detail. One standout influencer: the use of the term “nodule” in lieu of “cancer.” For example, subjects were equally likely to prefer a scenario with a papillary thyroid nodule carrying a 5% risk of progression as one with a papillary thyroid cancer carrying a 1% risk of progression. Not to mention over one-quarter(!) of all patients made “paradoxical” (i.e., irrational) choices for a worse outcome with a more aggressive treatment over a better outcome with observation alone if the choices used the label “cancer.” TBL: Cancer by any other name is much sweeter so consider your words wisely when offering active surveillance. | Dixon, JAMA Oncol 2019


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