• Michael Hoerger, Ronald M Epstein, Paul C Winters, Kevin Fiscella, Paul R Duberstein, Robert Gramling, Phyllis N Butow, Supriya G Mohile, Paul R Kaesberg, Wan Tang, Sandy Plumb, Adam Walczak, Anthony L Back, Daniel Tancredi, Alison Venuti, Camille Cipri, Gisela Escalera, Carol Ferro, Don Gaudion, Beth Hoh, Blair Leatherwood, Linda Lewis, Mark Robinson, Peter Sullivan, and Richard L Kravitz.
• Rochester Healthcare Decision-Making Group, University of Rochester Medical Center, Rochester, NY, USA. michael_hoerger@urmc.rochester.edu
• Bmc Cancer. 2013 Jan 1; 13: 188.

BackgroundCommunication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers.Methods/DesignThe Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years.DiscussionThe intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes).Trial RegistrationClinical Trials Identifier: NCT01485627.

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