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计算机决策辅助工具帮助早期甲状腺乳头状癌患者进行辅助放射性碘治疗决策的可用性研究。

A usability study of a computerized decision aid to help patients with, early stage papillary thyroid carcinoma in, decision-making on adjuvant radioactive iodine treatment.

机构信息

Department of Medicine, University Health Network - Toronto General Hospital, Toronto, Canada.

出版信息

Patient Educ Couns. 2011 Aug;84(2):e24-7. doi: 10.1016/j.pec.2010.07.038. Epub 2010 Aug 21.

Abstract

OBJECTIVE

We tested the usability of a patient-directed decision aid (DA), intended for patients with early stage papillary thyroid carcinoma (PTC) deciding to accept or reject adjuvant radioactive iodine (RAI) treatment. This decision is complicated by uncertainty of the medical evidence relating to potential treatment benefits.

METHODS

The DA was tested by 12 thyroid cancer survivors, 7 thyroid specialty physicians, and 30 lay individuals with no history of thyroid cancer. The participants completed the System Usability Scale for human-computer interaction questionnaire. The medical knowledge of lay participants was assessed before and after DA exposure. Qualitative participant feedback was obtained by thinking aloud during DA use, as well as from interviews.

RESULTS

Participants generally found the usability of the DA acceptable. The DA significantly increased medical knowledge. In spite of some physicians' concerns about disclosure of treatment controversy and evidence uncertainty, it was found to be acceptable to non-physicians.

CONCLUSION

A computerized DA on RAI treatment is acceptable to physicians and non-physicians and can improve medical knowledge.

PRACTICE IMPLICATIONS

In counseling patients about complex medical decisions, disclosure of uncertainty related to medical evidence may be acceptably conveyed using a DA.

摘要

目的

我们测试了一款面向早期甲状腺乳头状癌 (PTC) 患者的患者导向决策辅助工具 (DA) 的可用性,这些患者需要决定是否接受或拒绝辅助放射性碘 (RAI) 治疗。由于与潜在治疗益处相关的医学证据存在不确定性,因此该决策较为复杂。

方法

12 名甲状腺癌幸存者、7 名甲状腺专科医生和 30 名没有甲状腺癌病史的普通民众对 DA 进行了测试。参与者完成了人机交互系统可用性量表问卷调查。在 DA 暴露前后,对普通参与者的医学知识进行了评估。通过使用 DA 时的出声思维以及访谈获得了参与者的定性反馈。

结果

参与者普遍认为 DA 的可用性可以接受。DA 显著提高了医学知识。尽管一些医生对治疗争议和证据不确定性的披露表示担忧,但非医生群体认为这是可以接受的。

结论

针对 RAI 治疗的计算机化 DA 可被医生和非医生接受,并能提高医学知识。

实践意义

在为患者提供复杂的医疗决策咨询时,使用 DA 披露与医学证据相关的不确定性可能是可以接受的。

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