Perceptions of control and unrealistic optimism in early-phase cancer trials

Lynn Jansen, Daruka Mahadevan, Paul S. Appelbaum, William M.P. Klein, Neil D. Weinstein, Motomi (Tomi) Mori, Catherine Degnin, Daniel P. Sulmasy

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose Recent research has found unrealistic optimism (UO) among patient-subjects in early-phase oncology trials. Our aim was to investigate the cognitive and motivational factors that evoke this bias in this context. We expected perceptions of control to be a strong correlate of unrealistic optimism. Methods A study of patient-subjects enrolled in early-phase oncology trials was conducted at two sites in the USA. Respondents completed questionnaires designed to assess unrealistic optimism and several risk attribute variables that have been found to evoke the bias in other contexts. Results One hundred and seventy-one patient-subjects agreed to be interviewed for our study. Significant levels of perceived controllability were found with respect to all nine research-related questions. Perceptions of control were found to predict unrealistic optimism. Two other risk attribute variables, awareness of indicators (p=0.024) and mental image (p=0.022), were correlated with unrealistic optimism. However, in multivariate regression analysis, awareness and mental image dropped out of the model and perceived controllability was the only factor independently associated with unrealistic optimism (p<0.0001). Conclusion Patient-subjects reported that they can, at least partially, control the benefits they receive from participating in an early-phase oncology trial. This sense of control may underlie unrealistic optimism about benefiting personally from trial participation. Effective interventions to counteract unrealistic optimism may need to address the psychological factors that give rise to distorted risk/benefit processing.

Original languageEnglish (US)
Pages (from-to)121-127
Number of pages7
JournalJournal of Medical Ethics
Volume44
Issue number2
DOIs
StatePublished - Feb 1 2018

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optimism
cancer
Neoplasms
Optimism
Cancer
psychological factors
trend
Research
multivariate analysis
regression analysis
Multivariate Analysis
Regression Analysis
Psychology
participation
questionnaire
Oncology

Keywords

  • decision making
  • early phase cancer trials
  • informed consent
  • perceived control
  • research ethics
  • unrealistic optimism

ASJC Scopus subject areas

  • Health(social science)
  • Issues, ethics and legal aspects
  • Arts and Humanities (miscellaneous)
  • Health Policy

Cite this

Jansen, L., Mahadevan, D., Appelbaum, P. S., Klein, W. M. P., Weinstein, N. D., Mori, M. T., ... Sulmasy, D. P. (2018). Perceptions of control and unrealistic optimism in early-phase cancer trials. Journal of Medical Ethics, 44(2), 121-127. https://doi.org/10.1136/medethics-2016-103724

Perceptions of control and unrealistic optimism in early-phase cancer trials. / Jansen, Lynn; Mahadevan, Daruka; Appelbaum, Paul S.; Klein, William M.P.; Weinstein, Neil D.; Mori, Motomi (Tomi); Degnin, Catherine; Sulmasy, Daniel P.

In: Journal of Medical Ethics, Vol. 44, No. 2, 01.02.2018, p. 121-127.

Research output: Contribution to journalArticle

Jansen, L, Mahadevan, D, Appelbaum, PS, Klein, WMP, Weinstein, ND, Mori, MT, Degnin, C & Sulmasy, DP 2018, 'Perceptions of control and unrealistic optimism in early-phase cancer trials', Journal of Medical Ethics, vol. 44, no. 2, pp. 121-127. https://doi.org/10.1136/medethics-2016-103724
Jansen, Lynn ; Mahadevan, Daruka ; Appelbaum, Paul S. ; Klein, William M.P. ; Weinstein, Neil D. ; Mori, Motomi (Tomi) ; Degnin, Catherine ; Sulmasy, Daniel P. / Perceptions of control and unrealistic optimism in early-phase cancer trials. In: Journal of Medical Ethics. 2018 ; Vol. 44, No. 2. pp. 121-127.
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