Participants Peter Salgo, MD; John L. Fox, MD, MHA; Ira M. Klein, MD, MBA, FACP; Michael Kolodziej, MD; Bryan Loy, MD; and Irwin W. Tischler, DO, evaluate the use of quality-adjusted life-years and comparative effectiveness research (CER) to inform treatment decisions.
While it is important to measure and assess quality-adjusted life-years, Dr Kolodziej advises that finding a way to evaluate poor patient outcomes when conducting CER would provide valuable additional information. Dr Loy adds that when evaluating CER, it is imperative to understand what matters most to the various stakeholders.
Dr Tischler explains that patients and their families are often unaware of the costs of therapy. Although it is a difficult discussion to lead, it is important for clinicians to discuss cost with patients. Dr Fox adds that these discussions can help patients understand their options and what to expect. It is also important that clinicians establish trust with patients and caregivers and provide information regarding the risks and benefits of treatment, comments Dr Kolodziej. When patients with terminal diseases are fully informed about their options, most decide not to receive additional treatment, but rather to be kept comfortable, remarks Dr Fox.