Duke University School of Nursing, Durham, NC, USA.
Med Decis Making. 2010 Jul-Aug;30(4):464-73. doi: 10.1177/0272989X09360371. Epub 2010 Feb 16.
The decision aid called ''Adjuvant Online'' (Adjuvant! for short) helps breast cancer patients make treatment decisions by providing numerical estimates of treatment efficacy (e.g., 10-y relapse or survival). Studies exploring how patients' numeracy interacts with the estimates provided by Adjuvant! are lacking. Pooling across 2 studies totaling 105 women with estrogen receptor-positive, early-stage breast cancer, the authors explored patients' treatment expectations, perceived benefit from treatments, and confidence of personal benefit from treatments. Patients who were more numerate were more likely to provide estimates of cancer-free survival that matched the estimates provided by Adjuvant! for each treatment option compared with patients with lower numeracy (odds ratios of 1.6 to 2.4). As estimates of treatment efficacy provided by Adjuvant! increased, so did patients' estimates of cancer-free survival (0.37 > r(s) > 0.48) and their perceptions of treatment benefit from hormonal therapy (r(s) = 0.28) and combined therapy (r(s) = 0.27). These relationships were significantly more pronounced for those with higher numeracy, especially for perceived benefit of combined therapy. Results suggest that numeracy influences a patient's ability to interpret numerical estimates of treatment efficacy from decision aids such as Adjuvant!.
名为“辅助在线”（简称 Adjuvant!）的决策辅助工具通过提供治疗效果的数值估计（例如，10 年复发或生存）帮助乳腺癌患者做出治疗决策。缺乏研究探索患者的计算能力如何与 Adjuvant! 提供的估计值相互作用。作者通过对 2 项共纳入 105 例雌激素受体阳性、早期乳腺癌女性的研究进行汇总，探讨了患者的治疗期望、对治疗益处的感知以及对个人治疗益处的信心。与计算能力较低的患者相比，计算能力较强的患者更有可能提供与 Adjuvant! 为每种治疗方案提供的无癌症生存估计值相匹配的估计值（比值比为 1.6 至 2.4）。随着 Adjuvant! 提供的治疗效果估计值的增加，患者的无癌症生存估计值也随之增加（0.37 > r(s) > 0.48），他们对激素治疗（r(s) = 0.28）和联合治疗（r(s) = 0.27）的治疗益处的感知也随之增加。对于计算能力较高的患者，这些关系更为明显，尤其是对联合治疗益处的感知。结果表明，计算能力影响患者从 Adjuvant! 等决策辅助工具中解释治疗效果数值估计值的能力。
