Critical appraisal:Razzano A, Revelli A, Delle Piane L, Salvagno F, Casano S, Randaccio S, et al 2014

Critical Appraisal

Article being appraised

Razzano A, Revelli A, Delle Piane L, Salvagno F, Casano S, Randaccio S, et al. Fertility preservation program before ovarotoxic oncostatic treatments: role of the psychological support in managing emotional aspects. Gynecol Endocrinol 2014 Nov;30(11):822-4 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25054374.

Applicable clinical question

What impact does fertility counselling have on the quality of life, mental health and decision making processes of cancer patients?

Key Facts

Study Design

case series

Study aims:

To assess the role of a psychologist as part of a fertility preservation consultation for young women affected by cancer.

Number of Patients:

48

Female cancer patients aged 18-40 (mean 28 years) being offered mature oocyte or ovarian tissue cryopreservation as part of a fertility preservation program.

Reported outcome(s):

Emotional aspects elicted by the FP consultation (21 multiple choice questions).
Semi-structured interview accessing fears, hostility, expectaions.
STAI (stait and trait anxiety subscales) with >40 above normal levels of anxiety, administered afer consultation and then on return to home.

Results of outcome(s):

Questionnaire:71% presence of psychologist helpful
70.9% absolutely satisfying and 16.7% very satisfying the collaboration between gynaecologist and psychologist.
54.2% FP as important part of cancer therapy, 58.3% an open window towards future, 70.8% an option not to be wasted.
STAI: most patient reported high anxiety post consultation, state slightly higher than trait at T1 and after returning home both state and trait increased slightly (T2) however p value not reported.

Comments on results:

further results on high satisfaction with information provision, collaboration between oncology and fertility, fertility drs empathy. Interview data suggests diagnosis of cancer and fear of future impact experienced by women, different age groups cope differenly with threat to infertility.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias

High risk of bias

Comments: single institution. No pre measures to intervention to assess satisfaction, anxiety etc. No statistical analyses to assess meaning of STAI changes over time.

Size of effect

5	Reason for decision: This study utilises an interview, a study designed multiple-choice questionnaire and 1 pre-validated measure of anxiety, with no pre intervention measure and no statistical analyses to assess repeated measure differences across time.

Relevance of evidence