Rostom Alaa, O'Connor Annette, Tugwell Peter, Wells George
Department of Medicine, University of Ottawa, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ont., Ottawa, Canada K1Y 4E9.
Patient Educ Couns. 2002 Jan;46(1):67-74. doi: 10.1016/s0738-3991(01)00167-7.
Decision aids (DAs) are increasingly being developed to help patients make shared health care decisions with their practitioners. There are no formal comparisons of the efficacy of different delivery methods. Interactive computerized delivery methods have the advantage of allowing patients control over flow of information and to receive feedback on their comprehension. The purpose of this study was to compare the efficacy of an interactive computerized DA for women considering long-term hormone replacement therapy, to that of a validated audio-booklet version of the same intervention. Fifty-one peri-menopausal women were randomized to use either the computerized or the standard audio-booklet version of the DA. The computerized version presented identical information with the addition of feedback modules to reinforce the participant's understanding. The patients were interviewed with a pre- and post-intervention questionnaire. The computerized DA improved realistic expectations by 52.7% over baseline versus 27.6% with the audio-booklet (P=0.015). Knowledge (Kn) scores improved by 17.5 and 8.4% for the computer and standard DA groups, respectively (P=0.019). The results of this study have implications for future DA design, and other areas where patient Kn and understanding are important, such as in the setting of informed consent.
决策辅助工具（DAs）正越来越多地被开发出来，以帮助患者与医生共同做出医疗保健决策。目前尚无关于不同交付方式疗效的正式比较。交互式计算机交付方式的优点是允许患者控制信息流，并获得关于其理解情况的反馈。本研究的目的是比较一种交互式计算机决策辅助工具对考虑长期激素替代疗法的女性的疗效，与同一干预措施的经过验证的有声小册子版本的疗效。51名围绝经期女性被随机分配使用决策辅助工具的计算机版本或标准有声小册子版本。计算机版本呈现相同的信息，并增加了反馈模块以加强参与者的理解。在干预前后分别用问卷对患者进行访谈。与有声小册子相比，计算机决策辅助工具使现实期望比基线提高了52.7%，而有声小册子为27.6%（P = 0.015）。计算机决策辅助工具组和标准决策辅助工具组的知识（Kn）得分分别提高了17.5%和8.4%（P = 0.019）。本研究结果对未来决策辅助工具的设计以及患者知识和理解很重要的其他领域，如在知情同意的情况下，具有启示意义。
