Gurmankin Levy Andrea, Shea Judy, Williams Sankey V, Quistberg Alex, Armstrong Katrina
Center for Community Based Research, Dana-Farber Cancer Institute, 44 Binney Street, Smith 253, Boston, MA 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1893-8. doi: 10.1158/1055-9965.EPI-05-0482.
Accurate measurement of people's risk perceptions is important for numerous bodies of research and in clinical practice, but there is no consensus about the best measure.
This study evaluated three measures of women's breast cancer risk perception by assessing their psychometric and test characteristics.
A cross-sectional mailed survey to women from a primary care population asked participants to rate their chance of developing breast cancer in their lifetime on a 0% to 100% numerical scale and a verbal scale with five descriptive categories, and to compare their risk to others (seven categories). Six hundred three of 956 women returned the survey (63.1%), and we analyzed surveys from the 566 women without a self-reported personal history of breast or ovarian cancer.
Scores on the numeric, verbal, and comparative measures were correlated with each other (r > 0.50), worry (r > 0.51), the Gail estimate (r > 0.26), and family history (r > 0.25). The numerical scale had the strongest correlation with annual mammogram (r = 0.19), and its correlation with the Gail estimate was unassociated with participants' sociodemographics. The numerical and comparative measures had the highest sensitivity (0.89-0.90) and specificity (0.99) for identifying women with very high risk perception. The numerical and comparative scale also did well in identifying women with very low risk perception, although the numerical scale had the highest specificity (0.96), whereas the comparative scale had the highest sensitivity (0.89).
Different measures of women's perceptions about breast cancer risk have different strengths and weaknesses. Although the numerical measure did best overall, the optimal measure depends on the goals of the measure (i.e., avoidance of false positives or false negatives).
准确测量人们的风险认知对于众多研究领域和临床实践都很重要，但对于最佳测量方法尚无共识。
本研究通过评估三种测量女性乳腺癌风险认知的方法的心理测量学和测试特征来对其进行评价。
对来自初级保健人群的女性进行横断面邮寄调查，要求参与者在0%至100%的数字量表以及具有五个描述性类别的文字量表上对其一生中患乳腺癌的几率进行评分，并将自己的风险与其他人进行比较（七个类别）。956名女性中有603名回复了调查（63.1%），我们分析了566名无自我报告乳腺癌或卵巢癌个人病史女性的调查问卷。
数字、文字和比较测量方法的得分彼此相关（r>0.50），与担忧相关（r>0.51），与盖尔评估相关（r>0.26），与家族病史相关（r>0.25）。数字量表与年度乳房X光检查的相关性最强（r = 0.19），其与盖尔评估的相关性与参与者的社会人口统计学特征无关。数字和比较测量方法在识别风险认知非常高的女性方面具有最高的敏感性（0.89 - 0.90）和特异性（0.99）。数字和比较量表在识别风险认知非常低的女性方面也表现良好，尽管数字量表具有最高的特异性（0.96），而比较量表具有最高的敏感性（0.89）。
测量女性乳腺癌风险认知的不同方法各有优缺点。虽然数字测量方法总体上表现最佳，但最佳测量方法取决于测量的目标（即避免假阳性或假阴性）。
