Dataset Information

Dialysis physicians' referral behaviors for hemodialysis patients suspected of having cancer: A vignette-based questionnaire study.

ABSTRACT:

Background

Although cancer management in dialysis patients has become a commonly encountered issue, known as "onco-nephrology", few evidence-based clinical recommendations have been proposed. Here, we examined the variation in referral behaviors adopted by dialysis physicians on encountering dialysis patients with signs/symptoms suggestive of cancer.

Methods

We conducted a vignette-based study in August 2015. We sent a 14-page questionnaire to 191 dialysis physicians, including the representative dialysis facilities participating in a Japanese dialysis cohort (the Japan Dialysis Outcomes and Practice Patterns Study). Using vignette scenarios for respiratory, digestive, and urological areas, we assessed the referral behaviors (expert referral or not) adopted by dialysis physicians on encountering dialysis patients with symptoms suggestive of cancer. Each scenario contained three patient functional factors: age (60 or 75 years), performance status (PS 0 or 1), and cognitive dysfunction (absence or presence). We examined the association between physician factors, patient factors, and referral behaviors.

Results

We obtained 94 replies (response rate: 49.2%). For the respiratory scenarios, 38.3% and 51.9% of physicians reported watchful waiting when encountering bilateral and unilateral pleural effusion, respectively. In digestive and urologic scenarios, most physicians (>85%) selected expert referral. We detected differences in referral behaviors between scenarios with different cancer biological factors. However, we found consistency in referral behaviors within the same scenario, even with different patient functional factors (intra-class correlation coefficients within each scenario all >0.7).

Conclusions

Physicians' referral behaviors for dialysis patients suspected of having cancer vary for different cancer biological factors (probability of having cancer). However, the referral behaviors are similar for different patient functional factors (age, PS, and cognitive dysfunction).

SUBMITTER: Fukuma S

PROVIDER: S-EPMC6093689 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Dialysis physicians' referral behaviors for hemodialysis patients suspected of having cancer: A vignette-based questionnaire study.

Fukuma Shingo S Kimachi Miho M Omae Kenji K Kataoka Yuki Y Yamazaki Hajime H Muto Manabu M Akizawa Tadao T Yanagita Motoko M Fukuhara Shunichi S

PloS one 20180815 8

<h4>Background</h4>Although cancer management in dialysis patients has become a commonly encountered issue, known as "onco-nephrology", few evidence-based clinical recommendations have been proposed. Here, we examined the variation in referral behaviors adopted by dialysis physicians on encountering dialysis patients with signs/symptoms suggestive of cancer.<h4>Methods</h4>We conducted a vignette-based study in August 2015. We sent a 14-page questionnaire to 191 dialysis physicians, including th ...[more]

PMID: 30110392

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Dataset Information

Dialysis physicians' referral behaviors for hemodialysis patients suspected of having cancer: A vignette-based questionnaire study.

Background

Methods

Results

Conclusions

Publications

Dialysis physicians' referral behaviors for hemodialysis patients suspected of having cancer: A vignette-based questionnaire study.

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