Schwartz Lisa M, Woloshin Steven, Welch H Gilbert
VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
Med Decis Making. 2007 Sep-Oct;27(5):655-62. doi: 10.1177/0272989X07306786. Epub 2007 Sep 14.
Direct-to-consumer drug ads have been criticized for providing inadequate and misleading information. Requiring ads to include a table with data on drug benefits and side effects (derived from clinical trials) could help, provided that consumers understand such tabular information.
To determine if people could understand and use a 9-row x 2-column "study findings table'' presenting expected outcomes (both beneficial and harmful) with and without a drug.
A convenience sample of 274 participants: 186 recruited from alumni of Dartmouth's "Community Medical School'' public lecture series and Dartmouth Hitchcock's Center for Shared Decision Making and 88 veterans and their families recruited from waiting rooms in the Veterans Affairs outpatient clinic, White River Junction, Vermont.
Cross-sectional survey. Participants were tested on their comprehension of the study findings table about the drug tamoxifen used for the primary prevention of breast cancer--with no instructions on how to use the table.
Five comprehension questions testing how well participants could read and use the table with drug benefits and side effects data.
On average, participants correctly answered 4 of the 5 table comprehension questions: 89% correctly used the table to determine the percentage of women given tamoxifen who got a blood clot in their legs or lungs, and 71% were able to use data in the table to calculate the absolute difference in the proportion of women who got breast cancer in the tamoxifen v. the placebo group. Most participants were also able to use the table to make comparisons.
Most participants--even those with lower formal educational attainment--were able to understand and use the tabular data.
直接面向消费者的药品广告因提供的信息不足且具有误导性而受到批评。要求广告包含一个列出药物益处和副作用数据(源自临床试验)的表格可能会有所帮助,前提是消费者能够理解此类表格信息。
确定人们是否能够理解并使用一个9行×2列的“研究结果表格”,该表格呈现了使用药物和不使用药物时的预期结果(包括有益和有害的)。
274名参与者的便利样本:186名从达特茅斯“社区医学院”公开讲座系列的校友以及达特茅斯希区柯克共同决策中心招募,88名退伍军人及其家属从佛蒙特州怀特河交汇处退伍军人事务门诊候诊室招募。
横断面调查。参与者在未接受关于如何使用该表格的指导的情况下,接受关于他们对用于乳腺癌一级预防的他莫昔芬研究结果表格理解程度的测试。
五个理解问题,测试参与者读取和使用包含药物益处和副作用数据的表格的能力。
参与者平均正确回答了5个表格理解问题中的4个:89%的人正确使用该表格确定服用他莫昔芬的女性腿部或肺部出现血栓的百分比,71%的人能够使用表格中的数据计算他莫昔芬组与安慰剂组中患乳腺癌女性比例的绝对差异。大多数参与者也能够使用该表格进行比较。
大多数参与者——即使是那些正规教育程度较低的人——都能够理解并使用表格数据。