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头颈癌患者对治疗效果的优先考虑因素:一种新评估工具的评估

Patients' priorities among treatment effects in head and neck cancer: evaluation of a new assessment tool.

作者信息

Sharp H M, List M, MacCracken E, Stenson K, Stocking C, Siegler M

机构信息

MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois, USA.

出版信息

Head Neck. 1999 Sep;21(6):538-46. doi: 10.1002/(sici)1097-0347(199909)21:6<538::aid-hed7>3.0.co;2-z.

Abstract

BACKGROUND

Patients with head and neck cancer may face decisions between surgery or radiation (with or without chemotherapy) which involve significant trade-offs in functional outcomes. This preliminary investigation is designed to examine patients' priorities among the effects of treatments for head and neck cancer.

METHODS

A new instrument designed to allow patients to rank personal priorities among 12 treatment effects was developed and tested. A cross section of patients (19) from pretreatment and posttreatment time periods and 23 controls participated.

RESULTS

Preliminary findings indicate high individual variability, with some differences between groups according to treatment time. Differences between patients and controls are evident. We report test-retest reliability and the limitations of this new tool.

CONCLUSIONS

The data suggest that measures of health state values should be conducted with patients rather than healthy volunteers. Patients' priorities may be influenced by treatment and some values may be more susceptible to change with experience of treatment effects. This new tool may provide insight into how patients' prioritize the anticipated and experienced effects of treatment for head and neck cancers.

摘要

背景

头颈癌患者可能需要在手术或放疗(联合或不联合化疗)之间做出决定,这些治疗在功能结局方面存在重大权衡。这项初步调查旨在研究患者在头颈癌治疗效果中的优先事项。

方法

开发并测试了一种新工具,该工具可让患者对12种治疗效果的个人优先事项进行排序。来自治疗前和治疗后时间段的患者(19名)以及23名对照参与其中。

结果

初步结果表明个体差异很大,根据治疗时间不同组之间存在一些差异。患者与对照之间的差异很明显。我们报告了重测信度以及此新工具的局限性。

结论

数据表明,健康状态值的测量应以患者而非健康志愿者为对象。患者的优先事项可能会受到治疗的影响,并且一些价值观可能更容易随着治疗效果的体验而改变。这种新工具可能有助于深入了解患者如何对头颈癌治疗的预期和实际效果进行优先排序。

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