对基于网络的,交互式的,个性化的决策工具进行范围审查,以支持乳腺癌治疗和幸存者护理
Kaitlyn M Wojcik1, Dalya Kamil1, Julia Zhang2
1Health Equity and Decision Sciences Research Laboratory, Division of Intramural Research, National Institute On Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, 20892, USA.
Journal of cancer survivorship : research and practice
|March 28, 2024
概括
这次审查发现了54个个性化乳腺癌决策工具,但质量和可用性差异很大. 未来的工具需要多样化的测试,以获得公平的乳腺癌护理.
科学领域:
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
- 决策科学 决策科学 决策科学
背景情况:
- 个性化,基于Web的,交互式决策工具在临床环境中越来越多地使用.
- 这些工具旨在支持患者和临床医生进行复杂的乳腺癌治疗和幸存者护理决策.
研究的目的:
- 系统地审查和评估现有的个性化,基于网络的交互式决策工具,用于乳腺癌治疗和幸存者护理.
- 评估这些工具的特性,质量,有效性和可用性.
主要方法:
- 使用系统性审查的首选报告项目和范围审查的元分析扩展 (PRISMA-ScR) 框架进行了范围审查.
- 在PubMed和相关数据库中搜索了2013年至2023年间开发的工具.
- 提取了关于工具目的,人口,数据源,特征,结果,验证和可用性的数据,使用国际患者决策辅助标准 (IPDAS) 进行评估.
主要成果:
- 确定了54种工具,提供基于临床,基因组,行为和上下文因素的个性化乳腺癌结果和治疗建议.
- 虽然45个工具得到了验证,9个工具经过了可用性测试,但这些评估主要包括白人,受过教育和/或受保险的人群.
- 平均质量评估得分在63个可能得分中为16个,这表明存在显著的变化.
结论:
- 现有的乳腺癌决策工具的质量,有效性和可用性存在很大差异.
- 未来的开发和测试必须优先考虑多样化的群体,以确保这些工具的公平访问和有效性.
- 癌症幸存者和临床医生都应该在将其纳入护理决策之前批判性地评估工具的质量,有效性和可用性.
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