肺癌查的决策支持工具中的价值澄清方法:系统审查和内容分析.
Norah L Crossnohere1, Rosa Negash1, Manny Schwimmer1
1Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
概括
肺癌查 (LCS) 的决策支持工具通常使用值澄清,增加查的普及率. 然而,基于理论的方法用于明确的价值澄清被充分利用,限制了决策支持质量的潜在改进.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 决策科学 决策科学 决策科学
背景情况:
- 澄清价值对共享决策至关重要,特别是在肺癌查 (LCS) 中,因为复杂的利益-危害权衡.
- 基于理论的明确价值澄清方法被假设为最佳支持患者决策.
研究的目的:
- 在面向患者的LCS决策支持工具中描述价值澄清方法.
- 探索这些方法与行为/决策结果之间的关联.
主要方法:
- 对48项评估32个独特的LCS决策支持工具的研究进行了系统审查.
- 关于研究特征和价值澄清方法的数据提取 (明确,隐含,没有).
- 随机对照试验 (RCT) 的元分析,以评估工具对LCS吸收的影响.
主要成果:
- 超过80%的LCS决策支持工具包括价值澄清 (50%明确,50%隐含).
- 实验室试验表明,决策辅助工具的LCS概率翻了一番 (OR 1.98),这是由于明确或没有价值的澄清.
- 缺乏价值澄清的工具质量较差;基于理论的明确方法很少使用.
结论:
- 在LCS决策支持工具中,经常包含价值澄清,并加强选采用.
- 基于理论的明确价值澄清方法的不足利用限制了决策支持质量的潜在改进.
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