Physician communication and patient understanding of molecular testing of tumors.

Abstract

e18217 Background: Molecular testing is being used with increasing prevalence to diagnose and treat cancer. Novel technical terminology is required to describe this testing to patients; however, it is unknown what language is being used and whether this language is understood, This study aimed to determine how oncologists describe this testing to patients and whether patients understand the technical terms and conceptual topics used by physicians. Methods: Patients and oncologists were consented for this study at one academic and two community hospitals. Conversations including a discussion of molecular testing were recorded; patients were then interviewed to assess their understanding of the terminology and topics described by their physicians. Recordings were transcribed and qualitatively analyzed; descriptive statistics were calculated from the coded data to identify the most frequently used technical terms and conceptual topics, assess overall patient understanding, and calculate an understanding score for each patient. Results: Sixty conversations about molecular testing were observed and recorded between 60 patients and 19 physicians. Thirty-four different technical terms were used by oncologists to describe 5 technical themes (mutation, molecular testing, targeted therapy, driver mutation, and biomarker). Patients understood 45% of undefined technical terms and 43% of defined technical terms. Physicians explained why the molecular testing was ordered in 67% of conversations, with 71% of patients demonstrating understanding, and how the testing would determine the patient’s treatment in 93% of conversations, with 80% of patients demonstrating understanding. Conclusions: Oncologists use variable language to describe molecular testing to patients. Patients do not understand most of the terms being used and defining technical terms does not improve patient understanding. Despite this, oncologists are effectively communicating the purpose of molecular testing and the effect of such testing on patient treatment. Future studies are warranted to determine which language and methods are most effective for describing molecular testing to patients. Guidelines and training for oncologists may be beneficial.