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Use of Persuasive Language in Communication of Risk during Prostate Cancer Treatment Consultations

Author

Listed:
  • Aurash Naser-Tavakolian

    (Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Rebecca Gale

    (Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Michael Luu

    (Department of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • John M. Masterson

    (Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Abhishek Venkataramana

    (Department of Urology, University of Southern California, Los Angeles, CA, USA)

  • Dmitry Khodyakov

    (RAND Institute, Santa Monica, CA, USA)

  • Jennifer T. Anger

    (Department of Urology, University of California, San Diego, San Diego, CA, USA)

  • Edwin Posadas

    (Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Howard Sandler

    (Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Stephen J. Freedland

    (Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
    Section of Urology, Durham VA Medical Center, Durham, NC, USA)

  • Brennan Spiegel

    (Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA
    Department of Medicine, Divisions of Gastroenterology and Health Services Research, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

  • Timothy J. Daskivich

    (Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
    Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA)

Abstract

Background Physician treatment preference may influence how risks are communicated in prostate cancer consultations. We identified persuasive language used when describing cancer prognosis, life expectancy, and side effects in relation to a physician’s recommendation for aggressive (surgery/radiation) or nonaggressive (active surveillance/watchful waiting) treatment. Methods A qualitative analysis was performed on transcribed treatment consultations of 40 men with low- and intermediate-risk prostate cancer across 10 multidisciplinary providers. Quotes pertaining to cancer prognosis, life expectancy, and side effects were randomized. Coders predicted physician treatment recommendations from isolated blinded quotes. Testing characteristics of consensus predictions against the physician’s treatment recommendation were reported. Coders then identified persuasive strategies favoring aggressive/nonaggressive treatment for each quote. Frequencies of persuasive strategies favoring aggressive/nonaggressive treatment were reported. Logistic regression quantified associations between persuasive strategies and physician treatment recommendations. Results A total of 496 quotes about cancer prognosis ( n  = 127), life expectancy ( n  = 51), and side effects ( n  = 318) were identified. The accuracy of predicting treatment recommendation based on individual quotes containing persuasive language ( n  = 256/496, 52%) was 91%. When favoring aggressive treatment, persuasive language downplayed side effect risks and amplified cancer risk (recurrence, progression, or mortality). Significant predictors ( P  

Suggested Citation

  • Aurash Naser-Tavakolian & Rebecca Gale & Michael Luu & John M. Masterson & Abhishek Venkataramana & Dmitry Khodyakov & Jennifer T. Anger & Edwin Posadas & Howard Sandler & Stephen J. Freedland & Brenn, 2024. "Use of Persuasive Language in Communication of Risk during Prostate Cancer Treatment Consultations," Medical Decision Making, , vol. 44(3), pages 320-334, April.
    • Handle: RePEc:sae:medema:v:44:y:2024:i:3:p:320-334
    DOI: 10.1177/0272989X241228612
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