了解个性化风险预测工具 (VALUE-PERSARC) 在日常临床实践中如何支持软组织肉瘤患者的明智治疗决策 - - 一项混合方法研究
Anouk A Kruiswijk1, Ellen G Engelhardt2, Lisa A E Vlug3
1Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
概括
像PERSARC这样的风险预测模型 (RPM) 帮助临床医生估计软组织肉瘤 (STS) 患者的辅助治疗益处. 然而,由于对治疗可行性和模型准确性的担忧,它们没有用于共享决策.
科学领域:
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 风险预测模型 (RPM) 帮助软组织肉瘤 (STS) 的治疗决策.
- 在决策过程中RPMs的临床应用仍未得到充分研究.
- 了解个性化SARcoma Care (PERSARC) RPM的整合是至关重要的.
研究的目的:
- 调查PERSARC RPM在临床接触中的使用情况.
- 确定影响PERSARC在日常实践中的使用障碍和促进者的障碍.
主要方法:
- 在荷兰三家肉瘤中心进行融合混合方法设计.
- 定性采访 (患者n=15,临床医生n=8).
- 通过专题分析和SEIPS模型集成分析的定量调查 (n=50) 和咨询记录 (n=30).
主要成果:
- PERSARC主要支持临床医生提出的计划,而不是患者-临床医生选择权衡.
- 障碍包括对治疗可行性的怀疑,风险估计的准确性和时间限制.
- 促进者参与估计和沟通辅助治疗的好处.
结论:
- 在STS中,PERSARC并未被用于共享知情决策.
- 整合RPM需要解决对质量和治疗选择的担忧.
- 承认RPM在估计辅助治疗益处方面的作用是改善信息提供的关键.
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