患者在澳大利亚全科医院研究癌症相关症状的偏好:一个离散选择实验
Brent Venning1, Alison Pearce2, Richard De Abreu Lourenco3
1Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia, and Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
概括
澳大利亚成年人优先考虑更短的等待时间和更低的癌症诊断测试成本,特别是低风险症状. 患者的偏好对食管胃癌,肠癌和肺癌调查的决定有很大的影响.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 保持早期癌症诊断的平衡,避免对低风险症状进行不必要的测试至关重要.
- 以患者为中心的护理需要了解个人对诊断测试的偏好.
研究的目的:
- 调查澳大利亚公众对食道胃癌,肠癌或肺癌症状诊断测试的偏好.
- 确定影响癌症诊断途径患者选择的关键因素.
主要方法:
- 一个具有全国代表性的40岁以上澳大利亚人样本参与了离散选择实验 (DCE).
- DCEs呈现了不同症状的癌症积极预测值 (PPVs) (1-3%) 的场景,隐藏于参与者.
- 属性包括测试策略,GP熟悉度,等待时间,旅行和成本;偏好是使用logit模型建模的.
主要成果:
- 3013名参与者完成了食管胃癌,肠癌或肺癌的DCE.
- 等待时间和测试成本是偏好的主要驱动因素,其次是测试类型.
- 观察到偏好更具侵入性的测试,但参与者不太倾向于测试非常低风险症状 (≤1% PPV).
结论:
- 与访问相关的因素,特别是等待时间和测试成本,是患者对癌症调查偏好的最重要的决定因素.
- 系统性因素对患者对潜在癌症症状的诊断测试的决定产生深远的影响.
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