设计用于初级保健环境的肺癌查决策辅助:随机临床试验
Marilyn M Schapira1,2, Rebecca A Hubbard3, Jeff Whittle4,5
1Center for Health Equity Research and Promotion (CHERP), Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania.
JAMA network open
|August 30, 2023
概括
肺癌查决策工具提高了知识和查的普及率,尽管短期内没有显著减少决策冲突. 该工具可以为未来的肺癌查共享决策策略提供信息.
科学领域:
- 临床试验 临床试验
- 医疗保健服务研究 医疗服务研究
- 决策科学 决策科学 决策科学
背景情况:
- 建议在肺癌查 (LCS) 之前进行共享决策.
- 在临床实践中实施共享决策工具的证据有限.
- 开发了一个基于网络的决策支持工具,以帮助LCS决策.
研究的目的:
- 评估肺癌查决策工具 (LCSDecTool) 对决策质量和LCS吸收的影响.
- 评估与LCS相关的决策冲突,知识,遗憾和焦虑.
- 在六个月内确定LCSDecTool对LCS吸收的影响.
主要方法:
- 在三个退伍军人事务医疗中心进行了一项随机临床试验.
- 55-80岁的参与者有显著的吸烟史被随机分配到LCSDecTool或注意力控制.
- 主要结果是1个月的决策冲突;次要结果包括6个月的知识和LCS吸收.
主要成果:
- 1个月后,在各组之间没有观察到决定性冲突的显著差异.
- 在LCSDecTool组中,干预后立即以及1个月和3个月后,他们对LCS的知识显著增加.
- 在6个月后,LCSDecTool组的LCS吸收率明显高于LCSDecTool组 (37.7%对21.1%).
结论:
- 在1个月后,LCSDecTool并没有显著减少决策冲突.
- 这项干预措施有效地提高了参与者的知识和肺癌查吸收率.
- 研究结果支持使用LCSDecTool来加强共享决策并提高LCS率.
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