Patients With Unrealistic Expectations

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Sometimes even well-informed patients have blinders on about the potential of a treatment or clinical trial, writes Dr. Pauline Chen in the latest Doctor and Patient column.

Despite clearly understanding the purpose, and limits, of early-phase trials, the patients were also blinded by what researchers called an “unrealistic optimism,” or an optimistic bias, when it came to applying that knowledge to their own particular situations. A majority of patients assumed that the experimental drugs would control their cancer and that they would experience benefits but not complications.

In essence, they believed they would fare better than the average patient enrolled in the same trial.

“It’s the Lake Wobegon effect, ” said Dr. Daniel P. Sulmasy, senior author and a professor of medicine and ethics at the University of Chicago. “If you have more than 50 percent of patients saying their chances are better than average of avoiding some harm or obtaining some benefit, they are being unrealistically optimistic because you can’t say that most people are above average.”

To learn more, read the full column,