基于计算机的决策辅助对对乳腺癌易感性遗传检测知识,感知和意图的影响:一个随机对照试验
Michael J Green1, Susan K Peterson, Maria Wagner Baker
1Department of Humanities, Penn State College of Medicine, Hershey, Pa 17033, USA. mjg15@psu.edu
JAMA
|July 29, 2004
概括
基于计算机的决策辅助工具提高了对BRCA1和BRCA2遗传测试的了解,远远超过了对低风险女性的标准咨询. 然而,遗传咨询更好地减少了焦虑和改善了风险感知,建议为遗传性癌症风险评估量身定制的教育方法.
科学领域:
- 遗传学 是一个遗传学.
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 对遗传性癌症基因测试的需求日益增加,需要探索传统遗传咨询的教育替代方案.
- 初级保健机构需要高效和有效的方法来教育患者关于遗传检测选项.
研究的目的:
- 为了比较基于计算机的决策辅助与标准遗传咨询对教育妇女关于BRCA1和BRCA2遗传测试的有效性.
- 评估每个教育方法对知识,风险感知,测试意图和决策冲突的影响.
主要方法:
- 一项随机对照试验涉及211名女性,她们在6个美国医疗中心有乳腺癌的个人或家族病史.
- 参与者被分配到标准的遗传咨询或基于计算机的教育计划,其次是咨询.
- 结果包括知识,风险感知,测试意图,决策冲突,焦虑和满意度,根据风险状态进行分析.
主要成果:
- 在低风险妇女中,基于计算机的程序显著增加了知识,远远超过标准咨询.
- 这两种干预措施都降低了对乳腺癌的绝对风险;低风险女性的测试意图下降.
- 标准的遗传咨询导致了较低的决策冲突和较高的决策满意度在低风险的妇女中,并减少了所有参与者的焦虑.
结论:
- 一个交互式计算机程序可以有效地提高对低风险个体遗传性癌症遗传学的知识.
- 标准的遗传咨询仍然优于减少焦虑和改善准确的风险感知,特别是在高风险人群中.
- 基于计算机的工具可以作为低风险女性的独立教育干预措施,或作为接受遗传咨询的高风险女性的辅助.
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