乳腺癌重建的患者决策辅助:随机对照试验的系统审查和网络元分析
Yunjhen Su1,2, Chin-Yu Sun3, Wen-Kuan Chiu4,5
1School of Medicine, College of Medicine, Taipei Medical University.
Plastic and reconstructive surgery
|January 17, 2024
概括
基于网络的决策辅助工具 (DAs) 显著提高了接受乳房重建的妇女的知识和满意度. 本次审查强调基于网络的DA是帮助患者做出决定的最有效格式.
科学领域:
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
- 患者的决策制定 患者的决策
背景情况:
- 乳腺癌现在是女性最常见的癌症诊断,导致乳腺切除和随后的乳房重建率增加.
- 关于乳房重建的决策对患者来说存在挑战,需要有效的决策支持工具.
- 现有的决策辅助工具 (DA) 需要进一步研究以优化其有效性和格式.
研究的目的:
- 审查决策辅助工具 (DAs) 在协助女性做出乳房切除术后乳房重建决策方面的实用性.
- 为了比较不同格式的DA,以确定患者决策中最有效的类型.
主要方法:
- 在PubMed和Embase进行了系统的文献搜索,用于2022年10月之前发表的研究,使用关键词"乳房重建"和"决策辅助".
- 一个网络元分析包括14项随机对照试验 (RCT),涉及1401名患者.
- 收集的数据包括人口统计,决策结果和评估工具;偏差风险使用Cochrane风险偏差2工具进行了评估.
主要成果:
- 基于网络的DA显示了减少决策冲突的显著改善 (-0.3;95% CI, -0.56至-0.05).
- 基于网络的DA显示出对患者知识 (0.61;95% CI,0.01至1.21) 的最积极影响,并显著增加了患者满意度 (0.44;95% CI,0.15至0.72).
- 在各个子组中没有观察到决定后悔的显著减少.
结论:
- 基于网络的决策辅助工具被认为是支持患者做出乳房重建决策的最有利格式.
- 这些发现支持基于网络的DA的整合,以提高患者对乳房重建过程的理解和满意度.
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