{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:16:14Z","timestamp":1785035774476,"version":"3.55.0"},"reference-count":98,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"Dutch Cancer Society","doi-asserted-by":"crossref","award":["11547"],"award-info":[{"award-number":["11547"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Discordance between physicians\u2019 and patients\u2019 prognostic perceptions in advanced cancer care threatens informed medical decision-making and end-of-life preparation, yet this phenomenon is poorly understood. We sought to: (1) describe the extent and direction of prognostic discordance, patients\u2019 prognostic information preferences in cases of prognostic discordance, and physicians\u2019 awareness of prognostic discordance; and (2) examine which patient, physician, and caregiver factors predict prognostic discordance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Oncologists and advanced cancer patients (median survival \u226412 months; n = 515) from 7 Dutch hospitals completed structured surveys in a cross-sectional study. Prognostic discordance was operationalized by comparing physicians\u2019 and patients\u2019 perceptions of the likelihood of cure, 2-year mortality risk, and 1-year mortality risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prognostic discordance occurred in 20% (likelihood of cure), 24%, and 35% (2-year and 1-year mortality risk) of physician-patient dyads, most often involving patients with more optimistic perceptions than their physician. Among patients demonstrating prognostic discordance, the proportion who preferred not knowing prognosis varied from 7% (likelihood of cure) to 37% (1-year mortality risk), and 45% (2-year mortality risk). Agreement between physician-perceived and observed prognostic discordance or concordance was poor (kappa = 0.186). Prognostic discordance was associated with several patient factors (stronger fighting spirit, self-reported absence of prognostic discussions, an information source other than the healthcare provider), and greater physician-reported uncertainty about prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Up to one-third of the patients perceive prognosis discordantly from their physician, among whom a substantial proportion prefers not knowing prognosis. Most physicians lack awareness of prognostic discordance, raising the need to explore patients\u2019 prognostic information preferences and perceptions, and to tailor prognostic communication.<\/jats:p><\/jats:sec>","DOI":"10.1093\/oncolo\/oyad098","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T02:42:15Z","timestamp":1683772935000},"page":"e653-e668","source":"Crossref","is-referenced-by-count":14,"title":["Prevalence and Predictors of Physician-Patient Discordance in Prognostic Perceptions in Advanced Cancer"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-6688","authenticated-orcid":false,"given":"Naomi Cornelia Anna","family":"van der Velden","sequence":"first","affiliation":[{"name":"Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam , Amsterdam , The Netherlands"},{"name":"Quality of Care, Amsterdam Public Health , Amsterdam , The Netherlands"},{"name":"Cancer Treatment and Quality of Life, Cancer Center Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0165-1940","authenticated-orcid":false,"given":"Paul K J","family":"Han","sequence":"additional","affiliation":[{"name":"Behavioral Research Program, National Cancer Institute , Bethesda, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1274-5643","authenticated-orcid":false,"given":"Hanneke W M","family":"van Laarhoven","sequence":"additional","affiliation":[{"name":"Cancer Treatment and Quality of Life, Cancer Center Amsterdam , Amsterdam , The Netherlands"},{"name":"Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9082-5991","authenticated-orcid":false,"given":"Filip Y F L","family":"de Vos","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3521-2535","authenticated-orcid":false,"given":"Lizza E L","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases, GROW School for Oncology and Reproduction, Maastricht University Medical Center+ , Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0218-8436","authenticated-orcid":false,"given":"Sjaak A","family":"Burgers","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Ziekenhuis , Amsterdam , The 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