远程医疗对前列腺癌治疗决策的影响
Deborah T Glassman1, Christina Grindley1, John C Wahlstedt1
1Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Urology practice
|April 30, 2025
概括
远程医疗不会显著改变前列腺癌治疗决策,包括积极监测与最终治疗. 然而,远程医疗患者更有可能选择主动监测,可能是由于未测量的因素.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
背景情况:
- 在COVID-19后,远程医疗的使用急剧增加,患者对前列腺癌 (CaP) 管理的满意度得到证实.
- 关于远程医疗对CAP治疗决策的影响的数据有限.
研究的目的:
- 调查预约类型 (远程医疗与面对面) 是否影响CAP治疗选择.
- 为了比较主动监测 (AS) 与基于访问方式的最终治疗选择.
主要方法:
- 在NCI指定的中心对CaP治疗选择的回顾性分析 (2020年3月至2022年12月).
- 远程医疗和面对面访问的比较,使用千平方和t测试.
- 后勤回归用于识别影响AS选择的因素.
主要成果:
- 分析了968次CaP访问 (290次远程医疗,678次面对面).
- 远程医疗患者更有可能是白人,远程生活,并选择AS,辅助或复发性治疗 (未经调整的分析).
- 后勤回归显示,远程医疗并没有显著影响Gleason 6或3+4=7疾病的初始治疗AS选择.
结论:
- 远程医疗扩大了获得多学科CAP护理的机会,而不会显著改变低风险CAP的初始治疗决策.
- 远程医疗患者中较高的AS选择可能源于基线差异或未测量的社会经济/并发症因素.
- 医生在使用远程医疗进行CAP治疗讨论时,应该考虑潜在的影响.
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