乳腺癌专家对风险预测模型在临床实践中的看法及应用：一种混合方法研究
Breast cancer specialists' views on and use of risk prediction models in clinical practice: a mixed methods approach.
作者信息
Engelhardt Ellen G, Pieterse Arwen H, van Duijn-Bakker Nanny, Kroep Judith R, de Haes Hanneke C J M, Smets Ellen M A, Stiggelbout Anne M
机构信息
Department of Medical Decision Making, Leiden University Medical Center , Leiden , The Netherlands.
出版信息
Acta Oncol. 2015 Mar;54(3):361-7. doi: 10.3109/0284186X.2014.964810. Epub 2014 Oct 13.
PURPOSE
Risk prediction models (RPM) in breast cancer quantify survival benefit from adjuvant systemic treatment. These models [e.g. Adjuvant! Online (AO)] are increasingly used during consultations, despite their not being designed for such use. As still little is known about oncologists' views on and use of RPM to communicate prognosis to patients, we investigated if, why, and how they use RPM.
METHODS
We disseminated an online questionnaire that was based on the literature and individual and group interviews with oncologists.
RESULTS
Fifty-one oncologists (partially) completed the questionnaire. AO is the best known (95%) and most frequently used RPM (96%). It is used to help oncologists decide whether or not to recommend chemotherapy (>85%), to inform (86%) and help patients decide about treatment (>80%), or to persuade them to follow the proposed course of treatment (74%). Most oncologists (74%) believe that using AO helps patients understand their prognosis.
CONCLUSION
RPM have found a place in daily practice, especially AO. Oncologists think that using AO helps patients understand their prognosis, yet studies suggest that this is not always the case. Our findings highlight the importance of exploring whether patients understand the information that RPM provide.
目的
乳腺癌风险预测模型（RPM）可量化辅助性全身治疗的生存获益。这些模型[如辅助治疗在线（AO）]越来越多地在会诊中使用，尽管其并非为此用途而设计。由于对于肿瘤学家在使用RPM向患者传达预后方面的观点和使用情况仍知之甚少，我们调查了他们是否使用、为何使用以及如何使用RPM。
方法
我们分发了一份基于文献以及对肿瘤学家进行的个人和小组访谈的在线问卷。
结果
51名肿瘤学家（部分）完成了问卷。AO是最知名的（95%）且最常使用的RPM（96%）。它用于帮助肿瘤学家决定是否推荐化疗（>85%）、为患者提供信息（86%）并帮助患者决定治疗方案（>80%）或说服他们遵循提议的治疗方案（74%）。大多数肿瘤学家（74%）认为使用AO有助于患者了解其预后。
结论
RPM在日常实践中已占有一席之地，尤其是AO。肿瘤学家认为使用AO有助于患者了解其预后，但研究表明情况并非总是如此。我们的研究结果凸显了探究患者是否理解RPM所提供信息的重要性。
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