Understanding Treatment Preferences and Cognitive Outcomes in Patients with Gliomas

Abstract Objective: Understanding how glioma patients value specific cognitive outcomes is essential to personalizing their treatment plans. The purpose of this study was to identify the modifiable cognitive functions most affected by treatment and most important to patient quality of life. Methods: Patients with gliomas were prospectively enrolled in focus groups and individual interviews guided by a standardized guide focused on cognitive functions. Patient values and treatment preferences were elicited and compared to the frequency of reported deficits. NVivo natural language processing software was used to perform thematic analyses on qualitative data. Results: Twenty participants participated, of whom 60% were female. Racial identification consisted of 75% White, 15% Black/African American, and 10% other. The cognitive functions most essential to the quality of life in this cohort were a sense of self (80% of participants), memory (70% of participants), and communication (25% of participants). The functions that experienced the most deficits because of treatment were memory (65% of participants), concentration (65% of participants), and special senses (40% of participants). “Dealbreakers” to treatment were complete loss of independence, sense of self, and/or ability to interact with loved ones. Conclusions: Glioma patients in this study prioritized cognitive functions according to intrinsic values, personal identity, and their ability to interact with loved ones. For this cohort, memory, sense of self, and communication were most highly valued by patients. The next phase of this study will investigate the relative survival value of these key functions using patient preference elicitation to optimize surgical decision-making.