Centre for Medical Psychology and Evidence-based Decision-making, Department of Medicine, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Ann Oncol. 2012 Jul;23(7):1912-8. doi: 10.1093/annonc/mdr585. Epub 2012 Jan 18.
Cancer patients want access to reliable information about currently recruiting clinical trials.
Oncologists and their patients were randomly assigned to access a consumer-friendly cancer clinical trials web site [Australian Cancer Trials (ACT), www.australiancancertrials.gov.au] or to usual care in a cluster randomized controlled trial. The primary outcome, measured from audio recordings of oncologist-patient consultations, was the proportion of patients with whom participation in any clinical trial was discussed. Analysis was by intention-to-treat accounting for clustering and stratification.
Thirty medical oncologists and 493 patients were recruited. Overall, 46% of consultations in the intervention group compared with 34% in the control group contained a discussion about clinical trials (P=0.08). The mean consultation length in both groups was 29 min (P=0.69). The proportion consenting to a trial was 10% in both groups (P=0.65). Patients' knowledge about randomized trials was lower in the intervention than the control group (mean score 3.0 versus 3.3, P=0.03) but decisional conflict scores were similar (mean score 42 versus 43, P=0.83).
Good communication between patients and physicians is essential. Within this context, a web site such as Australian Cancer Trials may be an important tool to encourage discussion about clinical trial participation.
癌症患者希望能够获取有关正在招募的临床试验的可靠信息。
在一项以群组为单位的随机对照试验中，肿瘤学家及其患者被随机分配至访问一个面向消费者的癌症临床试验网站（澳大利亚癌症试验[ACT]，www.australiancancertrials.gov.au）或常规护理。主要结局指标为通过对肿瘤学家-患者咨询的音频记录进行测量，记录参与任何临床试验的患者比例。分析采用意向治疗方法，同时考虑了聚类和分层因素。
共招募了 30 名肿瘤学家和 493 名患者。总体而言，干预组中有 46%的咨询包含了关于临床试验的讨论，而对照组中这一比例为 34%（P=0.08）。两组的平均咨询时长均为 29 分钟（P=0.69）。两组患者同意参加试验的比例均为 10%（P=0.65）。干预组患者对随机试验的了解程度低于对照组（平均得分 3.0 对 3.3，P=0.03），但决策冲突得分相似（平均得分 42 对 43，P=0.83）。
患者与医生之间的良好沟通至关重要。在这种情况下，像澳大利亚癌症试验这样的网站可能是鼓励讨论参与临床试验的重要工具。
