在低风险甲状腺癌中确定治疗策略的共享决策:多中心集群随机试验 (MAeSTro-SDM) 协议
Eun Kyung Lee1,2, Min Joo Kim3, Yul Hwangbo1,2
1Center for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Journal of Korean medical science
|January 27, 2026
概括
一个新的共享决策 (SDM) 模型用于乳头甲状腺微癌 (PTMC) 改善了患者报告的结果. 这项研究评估了SDM模型与低风险PTMC患者的常规护理.
科学领域:
- 在瘤学瘤学.
- 医疗决策的制定 医疗决策的制定
- 公共卫生 公共卫生
背景情况:
- 建议对低风险的乳头甲状腺小癌 (PTMC) 进行积极监测 (AS),但实施共享决策 (SDM) 仍然具有挑战性.
- 将患者价值观纳入临床决策对于在PTMC管理中有效的AS至关重要.
- 现有的指导方针建议AS,但实际应用需要加强患者参与.
研究的目的:
- 评估一个新开发的PTMC特定的SDM模型对患者报告的结果 (PROs) 与常规护理 (UC) 相比的影响.
- 评估结构化咨询和决策辅助在改善患者满意度和决策过程中的有效性.
- 为将SDM整合到常规PTMC管理中提供证据.
主要方法:
- 一个多中心,并行组,集群随机对照试验,涉及7家韩国学术医院的310名低风险PTMC患者.
- 参与者通过临床医生的集群随机化被分配到SDM模型组或UC组.
- SDM组接受了具有决策辅助的结构化咨询;UC组接受了标准咨询.
主要成果:
- 主要结果是决策冲突量表得分,次要结果包括满意度,决策后悔,焦虑和生活质量.
- 数据收集涉及电子案例报告表格和PRO调查在基线,1-4周和决定后6个月.
- 这项研究旨在证明SDM组与UC组相比,SDM组的PRO有所改善.
结论:
- 特定于PTMC的SDM模型有可能提高低风险PTMC管理中的患者报告结果.
- 成功实施SDM可以提高患者满意度和决策过程.
- 这项试验为将SDM纳入低风险PTMC患者的日常护理提供了证据.
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