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一项整群随机对照试验中癌症患者不参与及退出的相关因素。

Factors associated with non-participation and dropout among cancer patients in a cluster-randomised controlled trial.

作者信息

Roick J, Danker H, Kersting A, Briest S, Dietrich A, Dietz A, Einenkel J, Papsdorf K, Lordick F, Meixensberger J, Mössner J, Niederwieser D, Prietzel T, Schiefke F, Stolzenburg J-U, Wirtz H, Singer S

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany.

Department of Obstetrics and Gynecology, University Medical Center Leipzig, Leipzig, Germany.

出版信息

Eur J Cancer Care (Engl). 2018 Jan;27(1). doi: 10.1111/ecc.12645. Epub 2017 Jan 30.

Abstract

We investigated the impact of demographic and disease related factors on non-participation and dropout in a cluster-randomised behavioural trial in cancer patients with measurements taken between hospitalisation and 6 months thereafter. The percentages of non-participation and dropout were documented at each time point. Factors considered to be potentially related with non-participation and dropout were as follows: age, sex, marital status, education, income, employment status, tumour site and stage of disease. Of 1,338 eligible patients, 24% declined participation at baseline. Non-participation was higher in older patients (Odds Ratio [OR] 2.1, CI: 0.6-0.9) and those with advanced disease (OR 2.0, CI: 0.1-1.3). Dropout by 6 months was 25%. Dropout was more frequent with increased age (OR 2.8, CI: 0.8-1.2), advanced disease (OR 3.0, CI: 1.0-1.2), being married (OR 2.4, CI 0.7-1.1) and less frequent with university education (OR 0.4, CI -1.3 to -0.8) and middle income (OR 0.4, CI -0.9 to -0.7). When planning clinical trials, it is important to be aware of patient groups at high risk of non-participation or dropout, for example older patients or those with advanced disease. Trial designs should consider their special needs to increase their rate of participation.

摘要

我们在一项针对癌症患者的整群随机行为试验中,调查了人口统计学和疾病相关因素对未参与及退出试验的影响,该试验在住院期间及之后6个月进行测量。记录了每个时间点的未参与率和退出率。被认为可能与未参与及退出相关的因素如下:年龄、性别、婚姻状况、教育程度、收入、就业状况、肿瘤部位和疾病分期。在1338名符合条件的患者中,24%在基线时拒绝参与。老年患者(优势比[OR]2.1,置信区间[CI]:0.6 - 0.9)和疾病晚期患者(OR 2.0,CI:0.1 - 1.3)的未参与率更高。到6个月时的退出率为25%。随着年龄增长(OR 2.8,CI:0.8 - 1.2)、疾病晚期(OR 3.0,CI:1.0 - 1.2)、已婚(OR 2.4,CI 0.7 - 1.1),退出情况更频繁;而大学学历(OR 0.4,CI -1.3至 -0.8)和中等收入(OR 0.4,CI -0.9至 -0.7)的患者退出情况较少。在规划临床试验时,了解有未参与或退出高风险的患者群体很重要,例如老年患者或疾病晚期患者。试验设计应考虑他们的特殊需求以提高参与率。

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