Zikmund-Fisher Brian J, Fagerlin Angela, Keeton Kristie, Ubel Peter A
Center for Practice Management & Outcomes Research, Health Services Research & Development Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Am J Obstet Gynecol. 2007 Nov;197(5):528.e1-6. doi: 10.1016/j.ajog.2007.03.076. Epub 2007 Sep 19.
We tested whether adding interpretive labels (eg, "negative test") to prenatal genetic screening test results changes perceived risk and preferences for amniocentesis.
Women (N = 1688) completed a hypothetical pregnancy scenario on the Internet. We randomly assigned participants into 2 groups: high risk of fetal chromosomal problems (12.5/1000) or low risk (2/1000). After prenatal screening, estimated risk was identical (5/1000) for all participants, but results were provided either alone or with interpretive labels.
When receiving test results without labels, all participants react similarly. With labels, the participants who received "positive" or "abnormal" results reported a higher perceived risk (P < .001), greater worry (P < .001), and greater interest in amniocentesis (57% vs 37%; P < .001) than did the participants who received "negative" or "normal" results.
Interpretive labels for test results can induce larger changes to a woman's risk perception and behavioral intention than can numeric results alone, which create decision momentum. This finding has broad clinical implications for patient-provider communication.
我们测试了在产前基因筛查测试结果中添加解释性标签(如“检测结果为阴性”)是否会改变对羊膜穿刺术的感知风险和偏好。
女性(N = 1688)在互联网上完成了一个假设的怀孕情景。我们将参与者随机分为两组:胎儿染色体问题高风险组(12.5/1000)或低风险组(2/1000)。产前筛查后,所有参与者的估计风险相同(5/1000),但结果要么单独提供,要么带有解释性标签。
在未收到带标签的检测结果时,所有参与者的反应相似。收到带标签的结果时,与收到“阴性”或“正常”结果的参与者相比,收到“阳性”或“异常”结果的参与者报告的感知风险更高(P < .001)、担忧更甚(P < .001),对羊膜穿刺术的兴趣也更高(57% 对 37%;P < .001)。
与单独的数字结果相比,检测结果的解释性标签对女性的风险感知和行为意图可能会产生更大的影响,数字结果仅产生决策动力。这一发现对医患沟通具有广泛的临床意义。