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Randomised trial of a decision aid and its timing for women being tested for a BRCA1/2 mutation.

作者信息

van Roosmalen M S, Stalmeier P F M, Verhoef L C G, Hoekstra-Weebers J E H M, Oosterwijk J C, Hoogerbrugge N, Moog U, van Daal W A J

机构信息

Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University Medical Center Nijmegen, Nijmegen, The Netherlands.

出版信息

Br J Cancer. 2004 Jan 26;90(2):333-42. doi: 10.1038/sj.bjc.6601525.

DOI:10.1038/sj.bjc.6601525
PMID:14735173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2410151/
Abstract

The aim of the study was to evaluate the impact of a decision aid (DA) and its timing in women being tested for a BRCA1/2 mutation. Women with and without a previous history of cancer were included after blood sampling for genetic testing. The DA consisted of a brochure and video providing information on screening and prophylactic surgery. To evaluate the impact of the DA, women were randomised to the DA group (n=184), receiving the DA 2 weeks after blood sampling, or to the control group (n=184). To evaluate the impact of timing, mutation carriers who had received the DA before the test result (n=47) were compared to mutation carriers who received the DA after the test result (n=42). Data were collected on well-being, treatment choice, decision and information related outcomes. The impact of the DA was measured 4 weeks after blood sampling. The impact of timing was measured 2 weeks after a positive test result. The DA had no impact on well-being. Regarding decision related outcomes, the DA group more frequently considered prophylactic surgery (P=0.02) corroborated with higher valuations (P=0.04). No differences were found for the other decision related outcomes. Regarding information related outcomes, the DA group felt better informed (P=0.00), was more satisfied with the information (P=0.00), and showed more accurate risk perceptions. Timing of the DA had no effect on any of the outcomes. No interactions were found between the DA and history of cancer. In conclusion, women being tested for a BRCA1/2 mutation benefit from the DA on information related outcomes. Because timing had no effect, the DA is considered useful either before or after the test result.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9909/2410151/37a1496f7bbb/90-6601525f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9909/2410151/37a1496f7bbb/90-6601525f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9909/2410151/37a1496f7bbb/90-6601525f1.jpg

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本文引用的文献

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Impact of BRCA1/2 testing and disclosure of a positive test result on women affected and unaffected with breast or ovarian cancer.
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Decision analysis of prophylactic surgery or screening for BRCA1 mutation carriers: a more prominent role for oophorectomy.BRCA1 突变携带者预防性手术或筛查的决策分析:卵巢切除术的作用更为突出。
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Effectiveness of decision aids for female BRCA1 and BRCA2 mutation carriers: a systematic review.决策辅助工具对女性 BRCA1 和 BRCA2 基因突变携带者有效性的系统评价。
BMC Med Inform Decis Mak. 2019 Aug 1;19(1):154. doi: 10.1186/s12911-019-0872-2.
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A patient decision aid for risk-reducing surgery in premenopausal BRCA1/2 mutation carriers: Development process and pilot testing.针对绝经前 BRCA1/2 突变携带者的降低风险手术的患者决策辅助工具:开发过程和试点测试。
Health Expect. 2018 Jun;21(3):659-667. doi: 10.1111/hex.12661. Epub 2017 Dec 27.
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