Lay Assessment of Health Care Services at the Example of Colon Cancer Treatment

Lay Assessment of Health Care Services at the Example of Colon Cancer Treatment Background: The aim was to determine differences in the assessment of treatment options in colon cancer by laypersons and experts and if the assessment depends on the form of presentation. Methods: Survival, recurrence rates, and side effects of 5 key studies of adjuvant treatment of colon cancer comparing two treatment options differing in the intensity of chemotherapy were displayed graphically. To determine the best form of presentation, two diagrams (squares and bars) were assessed by laypersons (n = 213) and medical personal (n = 26) and compared with recommendations of the treatment guidelines. Results: Laypersons preferred in 57-98% the less toxic treatment option. In one study with a survival benefit of more than 10% the superior treatment, which is associated with more side effects, was only chosen by 55% of laypersons, but by 92% of the medical personal. Assessments were comparable for laypersons and medical personal in studies without survival benefit. The type of presentation did not influence assessment. Conclusions: Complex scientific data can be presented that an evaluation is possible by laypersons. Less toxic treatment is preferred as long as there is no difference in survival. The decisions made were not always in accordance with the German guidelines for treatment of colon cancer.