Health Communication Program, RTI International, Research Triangle Park, NC 27709, USA.
Patient Educ Couns. 2013 Aug;92(2):188-96. doi: 10.1016/j.pec.2013.04.008. Epub 2013 May 9.
Women with hereditary breast and ovarian cancer syndrome (HBOC) face a higher risk of earlier, more aggressive cancer. Because of HBOC's rarity, screening is recommended only for women with strong cancer family histories. However, most patients do not have accurate history available and struggle to understand genetic concepts.
Cancer in the Family, an online clinical decision support tool, calculated women's HBOC risk and promoted shared patient-provider decisions about screening. A pilot evaluation (n=9 providers, n=48 patients) assessed the tool's impact on knowledge, attitudes, and screening decisions. Patients used the tool before wellness exams and completed three surveys. Providers accessed the tool during exams, completed exam checklists, and completed four surveys.
Patients entered complete family histories (67%), calculated personal risk (96%), and shared risk printouts with providers (65%). HBOC knowledge increased dramatically for patients and providers, and many patients (75%) perceived tool results as valid. The tool prompted patient-provider discussions about HBOC risk and cancer family history (88%).
The tool was effective in increasing knowledge, collecting family history, and sparking patient-provider discussions about HBOC screening.
Interactive tools can effectively communicate personalized risk and promote shared decisions, but they are not a substitute for patient-provider discussions.
遗传性乳腺癌和卵巢癌综合征（HBOC）患者面临更高的早期、侵袭性癌症风险。由于 HBOC 较为罕见，仅建议有强烈癌症家族史的女性进行筛查。然而，大多数患者无法提供准确的家族史，且难以理解遗传概念。
在线临床决策支持工具“Cancer in the Family”计算了女性的 HBOC 风险，并促进了有关筛查的医患共同决策。一项试点评估（n=9 名提供者，n=48 名患者）评估了该工具对知识、态度和筛查决策的影响。患者在健康检查前使用该工具，并完成了三项调查。提供者在检查期间访问该工具，填写检查清单，并完成了四项调查。
患者完成了完整的家族史（67%），计算了个人风险（96%），并与提供者共享了风险打印件（65%）。患者和提供者的 HBOC 知识显著增加，许多患者（75%）认为工具结果有效。该工具促使医患讨论 HBOC 风险和癌症家族史（88%）。
该工具在增加知识、收集家族史以及激发医患之间关于 HBOC 筛查的讨论方面非常有效。
交互式工具可以有效地传达个性化风险并促进共同决策，但不能替代医患讨论。
