Shared decision making in routine oncology appointments with Black patients with lung cancer

Katarina E. AuBuchon; Amanda Khoudary; Jennifer D. Rodriguez; Osairys M. Billini; Isabella Westervelt; Emily P. Taylor; Noelle Newton; Melody Emenyonu; Chul Kim; Irina Veystman; Jennifer Wheeley; Martin Gutierrez; Heather M. Derry-Vick; Claire C. Conley

doi:10.1007/s00520-025-09300-4

Shared decision making in routine oncology appointments with Black patients with lung cancer

Katarina E. AuBuchon, Amanda Khoudary, Jennifer D. Rodriguez, Osairys M. Billini, Isabella Westervelt, Emily P. Taylor, Noelle Newton, Melody Emenyonu, Chul Kim, Irina Veystman, Jennifer Wheeley, Martin Gutierrez, Heather M. Derry-Vick, Claire C. Conley

Hackensack Meridian School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: Poor clinician-patient communication may contribute to racialized inequities in cancer symptom burden. Shared decision-making (SDM) enhances clinician-patient communication, and could contribute to health equity for Black patients with cancer. However, research on SDM is limited for Black patients with cancer. Methods: This multi-method longitudinal observational study examined SDM during routine oncology follow-ups for patients with advanced lung cancer. We analyzed SDM reported by clinicians (n = 6), self-identified Black patients with lung cancer (n = 30), and coded from patient visit recordings (n = 20). We described the symptom management conversations, and examined how SDM related to patient satisfaction and symptom severity with two-sided correlations. Results: Most patients (85.0%) asked questions during appointments and discussed cancer-related symptoms (95.0%), most commonly pain/neuropathy (65.0%). Though coded SDM during symptom discussions was low, providers and patients reported high levels of SDM. Coded SDM did not statistically significantly correlate with post-appointment satisfaction (r = -.01, p >.10) or symptom burden (r =.04, p >.10). However, patient-reported SDM did relate to post-appointment satisfaction (r =.72, p =.08) and symptom burden (r =.35, p =.08) one month later. Conclusions: Through detailed multi-method analysis, we found that coded SDM did not correspond to patient and physician-reported SDM during routine oncology appointments. Patient-reported SDM correlated to several better physical and mental health outcomes as well as overall satisfaction a month later. Our findings highlight the complexities of clinician-patient communication and the importance of studying these processes for Black patients with cancer. Future research should develop culturally-relevant methods of assessing SDM with Black patients and understand Black patients’ communication needs.

Original language	English
Article number	250
Journal	Supportive Care in Cancer
Volume	33
Issue number	4
DOIs	https://doi.org/10.1007/s00520-025-09300-4
State	Published - Apr 2025

ASJC Scopus subject areas

Oncology

Keywords

Black Americans
Clinician-patient communication
Health disparities
Lung cancer
Shared decision making

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00520-025-09300-4

Cite this

AuBuchon, K. E., Khoudary, A., Rodriguez, J. D., Billini, O. M., Westervelt, I., Taylor, E. P., Newton, N., Emenyonu, M., Kim, C., Veystman, I., Wheeley, J., Gutierrez, M., Derry-Vick, H. M., & Conley, C. C. (2025). Shared decision making in routine oncology appointments with Black patients with lung cancer. Supportive Care in Cancer, 33(4), Article 250. https://doi.org/10.1007/s00520-025-09300-4

@article{d3ed1422529047679aa6dc33e335338f,

title = "Shared decision making in routine oncology appointments with Black patients with lung cancer",

abstract = "Purpose: Poor clinician-patient communication may contribute to racialized inequities in cancer symptom burden. Shared decision-making (SDM) enhances clinician-patient communication, and could contribute to health equity for Black patients with cancer. However, research on SDM is limited for Black patients with cancer. Methods: This multi-method longitudinal observational study examined SDM during routine oncology follow-ups for patients with advanced lung cancer. We analyzed SDM reported by clinicians (n = 6), self-identified Black patients with lung cancer (n = 30), and coded from patient visit recordings (n = 20). We described the symptom management conversations, and examined how SDM related to patient satisfaction and symptom severity with two-sided correlations. Results: Most patients (85.0%) asked questions during appointments and discussed cancer-related symptoms (95.0%), most commonly pain/neuropathy (65.0%). Though coded SDM during symptom discussions was low, providers and patients reported high levels of SDM. Coded SDM did not statistically significantly correlate with post-appointment satisfaction (r = -.01, p >.10) or symptom burden (r =.04, p >.10). However, patient-reported SDM did relate to post-appointment satisfaction (r =.72, p =.08) and symptom burden (r =.35, p =.08) one month later. Conclusions: Through detailed multi-method analysis, we found that coded SDM did not correspond to patient and physician-reported SDM during routine oncology appointments. Patient-reported SDM correlated to several better physical and mental health outcomes as well as overall satisfaction a month later. Our findings highlight the complexities of clinician-patient communication and the importance of studying these processes for Black patients with cancer. Future research should develop culturally-relevant methods of assessing SDM with Black patients and understand Black patients{\textquoteright} communication needs.",

keywords = "Black Americans, Clinician-patient communication, Health disparities, Lung cancer, Shared decision making",

author = "AuBuchon, {Katarina E.} and Amanda Khoudary and Rodriguez, {Jennifer D.} and Billini, {Osairys M.} and Isabella Westervelt and Taylor, {Emily P.} and Noelle Newton and Melody Emenyonu and Chul Kim and Irina Veystman and Jennifer Wheeley and Martin Gutierrez and Derry-Vick, {Heather M.} and Conley, {Claire C.}",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.",

year = "2025",

month = apr,

doi = "10.1007/s00520-025-09300-4",

language = "English",

volume = "33",

journal = "Supportive Care in Cancer",

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AuBuchon, KE, Khoudary, A, Rodriguez, JD, Billini, OM, Westervelt, I, Taylor, EP, Newton, N, Emenyonu, M, Kim, C, Veystman, I, Wheeley, J, Gutierrez, M , Derry-Vick, HM & Conley, CC 2025, 'Shared decision making in routine oncology appointments with Black patients with lung cancer', Supportive Care in Cancer, vol. 33, no. 4, 250. https://doi.org/10.1007/s00520-025-09300-4

TY - JOUR

T1 - Shared decision making in routine oncology appointments with Black patients with lung cancer

AU - AuBuchon, Katarina E.

AU - Khoudary, Amanda

AU - Rodriguez, Jennifer D.

AU - Billini, Osairys M.

AU - Westervelt, Isabella

AU - Taylor, Emily P.

AU - Newton, Noelle

AU - Emenyonu, Melody

AU - Kim, Chul

AU - Veystman, Irina

AU - Wheeley, Jennifer

AU - Gutierrez, Martin

AU - Derry-Vick, Heather M.

AU - Conley, Claire C.

N1 - Publisher Copyright: © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.

PY - 2025/4

Y1 - 2025/4

N2 - Purpose: Poor clinician-patient communication may contribute to racialized inequities in cancer symptom burden. Shared decision-making (SDM) enhances clinician-patient communication, and could contribute to health equity for Black patients with cancer. However, research on SDM is limited for Black patients with cancer. Methods: This multi-method longitudinal observational study examined SDM during routine oncology follow-ups for patients with advanced lung cancer. We analyzed SDM reported by clinicians (n = 6), self-identified Black patients with lung cancer (n = 30), and coded from patient visit recordings (n = 20). We described the symptom management conversations, and examined how SDM related to patient satisfaction and symptom severity with two-sided correlations. Results: Most patients (85.0%) asked questions during appointments and discussed cancer-related symptoms (95.0%), most commonly pain/neuropathy (65.0%). Though coded SDM during symptom discussions was low, providers and patients reported high levels of SDM. Coded SDM did not statistically significantly correlate with post-appointment satisfaction (r = -.01, p >.10) or symptom burden (r =.04, p >.10). However, patient-reported SDM did relate to post-appointment satisfaction (r =.72, p =.08) and symptom burden (r =.35, p =.08) one month later. Conclusions: Through detailed multi-method analysis, we found that coded SDM did not correspond to patient and physician-reported SDM during routine oncology appointments. Patient-reported SDM correlated to several better physical and mental health outcomes as well as overall satisfaction a month later. Our findings highlight the complexities of clinician-patient communication and the importance of studying these processes for Black patients with cancer. Future research should develop culturally-relevant methods of assessing SDM with Black patients and understand Black patients’ communication needs.

AB - Purpose: Poor clinician-patient communication may contribute to racialized inequities in cancer symptom burden. Shared decision-making (SDM) enhances clinician-patient communication, and could contribute to health equity for Black patients with cancer. However, research on SDM is limited for Black patients with cancer. Methods: This multi-method longitudinal observational study examined SDM during routine oncology follow-ups for patients with advanced lung cancer. We analyzed SDM reported by clinicians (n = 6), self-identified Black patients with lung cancer (n = 30), and coded from patient visit recordings (n = 20). We described the symptom management conversations, and examined how SDM related to patient satisfaction and symptom severity with two-sided correlations. Results: Most patients (85.0%) asked questions during appointments and discussed cancer-related symptoms (95.0%), most commonly pain/neuropathy (65.0%). Though coded SDM during symptom discussions was low, providers and patients reported high levels of SDM. Coded SDM did not statistically significantly correlate with post-appointment satisfaction (r = -.01, p >.10) or symptom burden (r =.04, p >.10). However, patient-reported SDM did relate to post-appointment satisfaction (r =.72, p =.08) and symptom burden (r =.35, p =.08) one month later. Conclusions: Through detailed multi-method analysis, we found that coded SDM did not correspond to patient and physician-reported SDM during routine oncology appointments. Patient-reported SDM correlated to several better physical and mental health outcomes as well as overall satisfaction a month later. Our findings highlight the complexities of clinician-patient communication and the importance of studying these processes for Black patients with cancer. Future research should develop culturally-relevant methods of assessing SDM with Black patients and understand Black patients’ communication needs.

KW - Black Americans

KW - Clinician-patient communication

KW - Health disparities

KW - Lung cancer

KW - Shared decision making

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U2 - 10.1007/s00520-025-09300-4

DO - 10.1007/s00520-025-09300-4

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JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

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ER -

Shared decision making in routine oncology appointments with Black patients with lung cancer

Abstract

ASJC Scopus subject areas

Keywords

UN SDGs

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