一项针对考虑进行乳腺癌和卵巢癌风险基因检测的女性的决策辅助工具的随机对照试验。

A randomized controlled trial of a decision aid for women considering genetic testing for breast and ovarian cancer risk.

作者信息

Wakefield Claire E, Meiser Bettina, Homewood Judi, Peate Michelle, Taylor Alan, Lobb Elizabeth, Kirk Judy, Young Mary-Anne, Williams Rachel, Dudding Tracy, Tucker Kathy

机构信息

Department of Psychology, Macquarie University, Sydney, NSW, Australia.

出版信息

Breast Cancer Res Treat. 2008 Jan;107(2):289-301. doi: 10.1007/s10549-007-9539-2. Epub 2007 Feb 27.

DOI:10.1007/s10549-007-9539-2

PMID:17333332

Abstract

PURPOSE

To measure the effectiveness of a tailored decision aid (DA) designed to help women make informed decisions about genetic testing for breast/ovarian cancer risk.

METHODS

A total of 145 women were randomized to receive the DA or a control pamphlet at the end of their first genetic counseling consultation. Of these, 120 (82.8%) completed two questionnaires, 1 week and 6 months post-consultation.

RESULTS

While the DA had no effect on informed choice, post-decisional regret or actual genetic testing decision, the trial showed that women who received the DA had higher knowledge levels and felt more informed about genetic testing than women who received the control pamphlet (chi(2)(2) = 6.82; P = 0.033; chi(2)(1) = 4.86; P = 0.028 respectively). The DA also helped women who did not have blood drawn at their first consultation to clarify their values with regards to genetic testing (chi(2)(1) = 5.27; P = 0.022). Women who received the DA were less likely to share the information with other family members than women in the control condition (chi(2)(1) = 8.78; P = 0.003).

CONCLUSIONS

Decision aids are an effective decision-support strategy for women considering genetic testing for breast/ovarian cancer risk, and are most effective before the patient has made a decision, which is generally at the point of having blood drawn.

摘要

目的

评估一种定制的决策辅助工具（DA）的有效性，该工具旨在帮助女性就乳腺癌/卵巢癌风险的基因检测做出明智决策。

方法

共有145名女性在首次基因咨询结束时被随机分组，分别接受决策辅助工具或对照宣传册。其中，120名（82.8%）在咨询后1周和6个月完成了两份问卷。

结果

虽然决策辅助工具对明智选择、决策后遗憾或实际基因检测决策没有影响，但试验表明，与接受对照宣传册的女性相比，接受决策辅助工具的女性知识水平更高，对基因检测了解更多（分别为χ²(2)=6.82；P = 0.033；χ²(1)=4.86；P = 0.028）。决策辅助工具还帮助那些在首次咨询时未抽血的女性明确了她们对基因检测的价值观（χ²(1)=5.27；P = 0.022）。与对照组女性相比，接受决策辅助工具的女性与其他家庭成员分享信息的可能性更小（χ²(1)=8.78；P = 0.003）。