Concordance in communication between surgeon and patient

OBJECTIVES: To examine (1) the capability of using interactive voice respon se (IVR) system technology for clinical research studies involving assessme nt of clinician-patient interactions and (2) the concordance of surgeons an d their breast cancer patients about the content of a postbiopsy pre-treatm ent decision meeting. DESIGN: A descriptive comparison of the perceptions of 2 volunteer groups - surgeons and their patients - using interactive voice technology. SETTING: Surgeons' offices. PARTICIPANTS: Twenty-six dyads of surgeons and their patients with newly di agnosed breast cancer. OUTCOME MEASURES: Concordance as determined through a Ii-item patient quest ionnaire and a parallel Ii-item surgeon questionnaire addressing surgical a nd psychosocial aspects of breast cancer treatment. RESULTS: Fifty-four percent to 100% of the 26 dyads indicated concordance a bout treatment preference, treatment choice, how treatment was chosen, pref erence for hom treatment was chosen, time for discussion about treatment, a nd discussion about lymph node removal. Only 27% to 50% of dyads agreed abo ut patient understanding of lymph-node removal, the thoroughness of discuss ions about adjuvant treatment, the thoroughness of discussion about emotion al coping, and the sufficiency of time for the discussion of patient's conc erns. In these areas of disagreement surgeons often underestimated the pati ent's ability to understand and underestimated the patient's perception of the thoroughness of discussions about the psychosocial aspects of the illne ss (concerns and coping). CONCLUSION: Surgeons and patients demonstrated concordance on their percept ions of the type of. treatment desired and needed but were discordant on th eir perceptions of the degree of patients' understanding about post-treatme nt and psychosocial issues.