Critical appraisal:Yee S 2016
Critical Appraisal
Yee S. Factors associated with the receipt of fertility preservation services along the decision-making pathway in young Canadian female cancer patients. J Assist Reprod Genet 2016 Feb;33(2):265-80 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26560157.
Key Facts
case series
This study investigated the factors associated with the receipt of fertility preservation (FP) services along the decision-making pathway in young Canadian female cancer patients. The roles of the oncologists were examined.
188
Our findings suggest that not only was the proactive approach of oncologists in initiating a fertility discussion im- portant, the quality of the discussion was equally critical in the decision-making pathway.
The mean ages of participants at diagnosis and at survey time were 30.2 (SD=3.7) and 33.9 (SD=5.9). One quarter (n=45, 23.9 %) did not recall having a fertility discus- sion with their oncologists. Of the three quarters who had a fertility discussion (n=143, 76.1 %), discussions were equally initiated by oncologists (n=71) and patients (n=72). Of the 49 women (26 %) who consulted a fertility specialist, 17 (9 %) underwent a FP procedure. Fertility concern at diagnosis was the driving force of the receipt of FP services at all decision points.
Oncologists play a pivotal role in the provision of fertility services in that they are not only gate keepers, knowledge brokers, and referral initiators of FP consultation, but also they are catalysts in supporting cancer patients mak- ing important FP decision in conjunction with the consultation provided by a fertility specialist.
no
Evidence ratings
IV
| High risk of bias | Comments: Survey - no participation rate |
| 2 | Additional comments: evidence of an effect on a surrogate that has been shown to be predictive of patient related outcomes |
Included
This appraisal has been completed.
- Article
- Yee S. Factors associated with the receipt of fertility preservation services along the decision-making pathway in young Canadian female cancer patients. J Assist Reprod Genet 2016 Feb;33(2):265-80 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26560157.
- Assigned to
- User:Antoinette.anazodo
- Topic area
- Guidelines:COSA:Cancer fertility preservation guidelines/Referral to fertility specialists
- Clinical question
Section below only relevant for Cancer Council Project Officer
Medical oncologists were involved in the fertility discus- sions of 97 cases (67.8 %), gynecologic oncologists in 29 cases (20.3 %), surgical oncologists in 28 cases (19.6 %), and radiation oncologists in 23 cases (16.1 %). Three quarters (n = 108, 75.5 %) had fertility discussion with one oncologist only; the remaining had fertility discussion with two oncolo- gists (n=25, 17.5 %) and three oncologists (n=10, 7 %). Forty-nine women consulted a fertility specialist following a fertility discussion with their oncologists. Among those who did not receive a FPC despite having a fertility discussion with their oncologist, 43.5 % would have definitely or probably chosen to be referred if they were given a chance, and 27.2 % were uncertain, whereas 29.3 % would have probably or definitely chosen not to be referred.
Of the 72 women (50.2 %) whose fertility discussions were self-initiated, only 1 in 4 (25 %) was satisfied with how their oncologists handled their fertility discussion.
Of the 71 women (49.7 %) whose fertility discussions were initiated by their oncologists, nearly 2 in 3 (63.4 %) were satisfied with how their oncologists handled their fertility discussion
Compared with participants whose fertility discussions were initiated by their oncologist, those whose discussions were self-initiated had a significantly high level of fertility concern at diagnosis (86.1 % versus 54.9 %)
Compared with participants whose fertility discussions were initiated by their oncologist, those whose discussions were self-initiated had a significantly high level of fertility concern at diagnosis (86.1 % versus 54.9 %)