Patient and oncologist expectations of functional prognosis among older adults with acute myeloid leukemia.

We explored this among patients with acute myeloid leukemia (AML) and their oncologists in a pilot randomized controlled trialtesting a decisional support tool (University of Rochester-Geriatric Oncology Assessment for Acute Myeloid Leukemia [UR-GOAL]).

我们在一项针对急性髓性白血病（AML）患者及其肿瘤科医生的试点随机对照试验中探索了这一点，该试验测试了一种决策支持工具（罗切斯特大学-急性髓性白血病老年肿瘤学评估[UR-GOAL]）。

We included adults aged ≥60 years with newly diagnosed AML, randomized 1:1 to UR-GOAL (AML educational video, assessment of aging-related conditions, values, and prognostic awareness) or usual care (UC).

我们纳入了年龄≥60岁、新诊断为急性髓性白血病（AML）的成人患者，按1:1的比例随机分配至UR-GOAL（AML教育视频、评估与年龄相关的状况、价值观和预后意识）组或常规护理（UC）组。

After initiating treatment, patients and oncologists reported whether they expected the patient's physical function to decline, improve, or stay the same over the next 6 months and 1 year (functional prognosis).

治疗开始后，患者和肿瘤科医生报告了他们是否预期患者在接下来的6个月和1年内身体功能会下降、改善或保持不变（功能预后）。

We estimated patient oncologist agreement using weighted κ statistics and evaluated differences by study arm.

我们使用加权κ统计量估计了患者与肿瘤学家之间的一致性，并通过研究组别评估了差异。

Of 100 enrolled patients, 77, who received care from 8 oncologists, responded to questions about the patient's functional prognosis.

在100名入组患者中，有77名患者接受了来自8名肿瘤学家的治疗，并对患者的功能预后问题做出了回应。

Patients had a mean age of 73 years (standard deviation, 6.8), and 39% were female.

患者的平均年龄为73岁（标准差为6.8），其中39%为女性。

Fewer patients (15% at 6 months, 20% at 1 year) anticipated that their function would decline, compared with their oncologists (51% at 6 months, 54% at 1 year).

较少的患者预计他们的功能会下降（6个月时为15%，1年时为20%），与他们的肿瘤医生的预测（6个月时为51%，1年时为54%）相比。

Most patients (68%) had discordant expectations from their oncologist, with κ = 0.10 (6 months) and κ = 0.07 (1 year).

大多数患者（68%）与肿瘤科医生的期望不一致，6个月时的κ值为0.10，1年时的κ值为0.07。

However, clinically meaningful discordance (patient: maintain or improve; oncologist: decline) was less common among UR-GOAL patients vs UC (27% vs 56%; P = .010).

然而，临床上有意义的不一致（患者：维持或改善；肿瘤科医生：恶化）在UR-GOAL患者中比在UC患者中少见（27% vs 56%；P = .010）。

Older adults with AML have expectations about their future physical function that differ from their oncologists.

患有急性髓细胞性白血病（AML）的老年人对于他们未来身体功能的期望与他们的肿瘤医生存在差异。

UR-GOAL may reduce this discordance.

UR-GOAL可能减少这种不一致。

This trial was registered at www.ClinicalTrials.gov as NCT05335369.

该试验已在www.ClinicalTrials.gov注册，注册号为NCT05335369。