Schapira Marilyn M, Gilligan Mary Ann, McAuliffe Timothy, Garmon Gwenn, Carnes Molly, Nattinger Ann B
The Clement J. Zablocki VA Medical Center, The Division of General Internal Medicine, Medical College of Wisconsin, Wisconsin, USA.
Patient Educ Couns. 2007 Jul;67(1-2):100-7. doi: 10.1016/j.pec.2007.02.007. Epub 2007 Apr 2.
Decision-making at menopause remains a challenge for women and their health care providers as the paradigm for hormone therapy continues to evolve. The role of decision-support for this process remains to be defined.
A randomized controlled trial of a computer-based hormone therapy (HT) decision-aid versus a control intervention consisting of a printed pamphlet among 177 post-menopausal women receiving care in a Veterans Affairs Medical Center.
Participants found the computer-based decision-aid easy to use and retained risk information incorporated from emerging scientific data. There was no difference between groups with respect to the primary outcomes of knowledge, satisfaction with decision, decisional conflict or HT use. A trend was reported towards decreased decisional conflict in the evidence in decision-making (p=0.07) and factors of uncertainty (p=0.06) domains among the subset of participants who were on HT at baseline and used the computer-based decision-aid.
The computer-based decision-aid was able to effectively incorporate emerging scientific information but was no more effective than a printed pamphlet control with regard to improving decision-process outcomes.
The incremental benefit of a complex versus simpler decision-aid for post-menopausal women remains to be established prior to widespread dissemination of interactive computer-based HT decision-aids.
随着激素疗法的模式不断演变，绝经后的决策对女性及其医疗服务提供者来说仍是一项挑战。决策支持在这一过程中的作用仍有待确定。
在一家退伍军人事务医疗中心接受治疗的177名绝经后女性中，进行一项基于计算机的激素疗法（HT）决策辅助工具与由印刷小册子组成的对照干预的随机对照试验。
参与者发现基于计算机的决策辅助工具易于使用，并保留了新出现的科学数据中的风险信息。在知识、对决策的满意度、决策冲突或HT使用等主要结果方面，两组之间没有差异。据报告，在基线时使用HT并使用基于计算机的决策辅助工具的参与者子集中，决策证据中的决策冲突（p=0.07）和不确定性因素（p=0.06）领域有减少的趋势。
基于计算机的决策辅助工具能够有效地纳入新出现的科学信息，但在改善决策过程结果方面并不比印刷小册子对照更有效。
在广泛传播基于计算机的交互式HT决策辅助工具之前，复杂决策辅助工具与简单决策辅助工具对绝经后女性的增量益处仍有待确定。
