Impact of Physicians’ Personalities and Behavioral Traits on Treatment-Related Decision-making for Elderly Acute Myeloid Leukemia

Abstract

Background

Elderly patients with acute myeloid leukemia (AML) can be treated with intensive therapy, low-intensity therapy, or best supportive care. Medical decision-making might be affected by physicians’ occupational and non-occupational factors.

Objective

To explore the impact of physicians’ personalities and behavioral traits on treatment-related decision-making for elderly AML patients.

Design

A nationwide cross-sectional survey.

Participants

Hematologists in mainland China (N = 529; response rate 64.5%).

Main Measures

The medical decision-making for elderly AML patients was evaluated using 6 clinical vignettes. Hematologists’ attitudes toward risk and uncertainty, Big Five personality traits, and decision-making styles were assessed using binary lottery choices and well-recognized self-report inventories.

Key Results

The resulting binary regression model in predicting treatment intensity contained professional title group (OR = 0.012, 95% CI 0.001 to 0.136, P < 0.001), conscientiousness (OR = 0.336, 95% CI 0.121 to 0.932, P = 0.036), extraversion (OR = 0.403, 95% CI 0.166 to 0.974, P = 0.044), conscientiousness by title group (OR = 2.009, 95% CI 1.100 to 3.667, P = 0.023), and extraversion by title group (OR = 1.627, 95% CI 0.965 to 2.743, P = 0.068) as predictors of therapy intensity preference. Junior physicians with a higher level of extraversion (mean difference = 0.27; 95% CI 0.07 to 0.45; P = 0.009) or conscientiousness (mean difference = 0.19; 95% CI 0.01 to 0.36; P = 0.028) tended to prescribe more intensive therapy. Meanwhile, no significant correlation was found between physicians’ personalities or behavioral traits and treatment-related decision-making in senior physicians.

Conclusions

Physicians’ personalities contribute to treatment-related decision-making for elderly AML patients, depending on the professional titles. More extravert or conscientious attending physicians tended to prescribe more intensive therapy. Meanwhile, the decisions made by chief and associate chief physicians were not impacted by their personal traits. Junior physicians should be aware of such potential influence when making medical decisions.

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Acknowledgments

The authors thank all the hematologists who participated in the survey.

Funding

Institutional research funding was provided by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (Grant No. 2019-RC-HL-001, for X.-x.C.), the National Natural Science Foundation of China (Grant No. 81570195, for L.J.), and Beijing Natural Science Foundation (Grant No. 7182128, for L.J.).

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Correspondence to Xin-xin Cao MD or Jian Li MD.

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Prior Presentations

This work was presented as a poster at the 62nd ASH Annual Meeting and Exposition (December 5, 2020).

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Wu, X., Jiang, Yn., Zhang, Yl. et al. Impact of Physicians’ Personalities and Behavioral Traits on Treatment-Related Decision-making for Elderly Acute Myeloid Leukemia. J GEN INTERN MED (2021). https://doi.org/10.1007/s11606-020-06467-w

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KEY WORDS

  • elderly acute myeloid leukemia
  • treatment-related decision-making
  • personality
  • physician