Communicating Uncertainties Associated With the Benefits and Risks of New Cancer Drugs

Summary

This nationally representative randomized survey of US adults will evaluate the effect of using brief statements to communicate different sources of uncertainty about the benefits and harms of new cancer drugs on participants' decisions and understanding.

Detailed description

Many newer cancer drugs are approved before uncertainties with their underlying clinical trial evidence have been adequately studied, in turn making it difficult to accurately determine the drug's benefits and harms. Prescription drug information rarely communicates these uncertainties. In a nationally representative sample of US adults, this study will evaluate the effect of using brief statements to communicate different sources of uncertainty about the benefits and harms of new cancer drugs on participants' decisions and understanding. In the pre-intervention phase, participants will be given information about a hypothetical new drug approved for the treatment of non-small cell lung cancer. Participants will be asked how likely they would be to take the drug, and how certain they are that the drug will work. Participants will then be randomized to 1 of 5 statements about a source of uncertainty with the drug's evidence that were based on the most common sources of uncertainties with new cancer drugs that are cited in FDA approval decisions: (1) single-arm trial designs, (2) limited study populations (i.e., generalizability of clinical trial evidence), and (3) limited study durations (i.e., long-term benefits and harms). Two additional uncertainties were also included that are frequently mentioned in the scientific literature: (4) the use of unvalidated surrogate endpoints to support new cancer drug approvals, and (5) uncertain treatment effect size (i.e., the magnitude of therapeutic benefit). The post-intervention questions will re-assess participants' decision making and perceptions of uncertainty, as well as their understanding of the uncertainty communicated in the statement.

Arms & interventions

• OtherStatement communicating uncertainty with a single arm trial

  Because Zenova has not been compared to other treatments, it is unknown if Zenova is better, the same, or worse than other treatments for non-small cell lung cancer.

• OtherStatement communicating uncertainty with limited study duration

  Since patients given Zenova were followed for a short time, the longer-term benefits and harms of taking Zenova are unknown.

• OtherStatement communicating uncertainty with a limited study population

  Zenova has not been studied in patients similar to Alex (patients with her race and ethnicity). It is unknown whether Zenova will work and what harms it will have for patients like her.

• OtherStatement communicating uncertainty with an unvalidated surrogate endpoint

  Zenova has only been shown to shrink the size of tumors. It is unknown whether Zenova improves how patients feel or how long they live.

• OtherStatement communicating uncertainty with treatment effect size

  It is unknown whether patients with non-small cell lung cancer will notice an improvement with Zenova.

Outcome measures

Eligibility criteria