Japanese hematologists’ and oncologists’ perceptions of patient preferences for shared decision-making

OBJECTIVES: Shared decision-making (SDM) is a key component of patient-centered oncology care, yet little is known about how Japanese physicians perceive their patients' roles in treatment decisions for diffuse large B-cell lymphoma (DLBCL). This study aimed to assess physicians' assumptions about patient preferences regarding SDM and to identify factors associated with these perceptions. RESULTS: An online survey was completed by 227 hematologists and oncologists in Japan who had managed at least one DLBCL case in the past year. Most physicians believed patients prefer collaborative decision-making: 34.4% selected joint decision-making, 31.7% patient-led after physician input, and 26.4% physician-led incorporating patient input. Few perceived patients as preferring full autonomy (7.5%), and none indicated fully physician-led decisions. Greater experience with refractory patients was linked to more physician-led perceptions (OR = 0.95 per patient, p = 0.0033). Female physicians more often endorsed patient-led preferences (OR = 0.39, p = 0.0436), while those aged ≥60 years favored physician-led models (OR = 2.33, p = 0.0454). University hospital affiliation showed a trend toward more patient-led perceptions (OR = 0.65, p = 0.087). Overall, Japanese physicians predominantly assumed patients prefer shared rather than extreme decision-making roles.