在线交互决策工具对女性关于乳腺癌查的决策的影响:系统审查和元分析
Patricia Villain1, Laura Downham1, Alice Le Bonniec1
1International Agency for Research on Cancer, World Health Organization, Lyon, France.
Journal of medical Internet research
|January 29, 2025
概括
定制的电子工具可以改善乳腺癌查 (BCS) 的参与和知识,但可能会增加担忧. 功能与定制电子工具可以减少决策冲突,但也减少BCS意图. 建议采用"按需"的分层方法.
科学领域:
- 数字健康数字健康
- 健康决策的制定方法
- 癌症查技术的使用
背景情况:
- 在线决策辅助工具 (DAs) 和电子工具为女性乳腺癌查 (BCS) 乳房造 mammography 决策提供了可访问的支持.
- 这些数字工具有可能增强参与BCS计划的机会.
研究的目的:
- 系统地审查和元分析BCS电子工具对妇女决策的影响的证据.
- 确定影响这些数字健康干预措施有用性和有效性的因素.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 在2010年8月至2023年4月期间搜索了多个数据库 (MEDLINE,PsycINFO,Embase,CINAHL,Web of Science).
- 包括使用DA/电子工具对平均风险人群的研究,评估BCS参与或决策决定因素;RCT的元分析与RoB 2评估.
主要成果:
- 在31篇论文中确定了22个电子工具;定制是关键因素.
- 定制的电子工具显著增加了长期的BCS参与 (RR 1.14).
- 功能与定制电子工具增加了知情选择 (RR 1.60) 和减少决策冲突 (RR 0.77),但也增加了负面的BCS意图 (RR 1.88). 根据风险量身定制的工具增加了担忧 (MD 0.31).
结论:
- 功能与定制电子工具可能通过培养负面意图对BCS程序产生负面影响.
- 量身定制的电子工具可以增强BCS参与,但当风险量身定制时,可能会增加担忧.
- 建议采用"按需"分层方法,以优化电子工具的有效性并最大限度地减少不良影响.
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