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关于乳腺钼靶筛查证据与争议的个性化知情选择:一项随机对照试验的研究方案

Personalised informed choice on evidence and controversy on mammography screening: study protocol for a randomized controlled trial.

作者信息

Roberto Anna, Colombo Cinzia, Candiani Giulia, Giordano Livia, Mantellini Paola, Paci Eugenio, Satolli Roberto, Valenza Mario, Mosconi Paola

机构信息

IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20157, Milan, Italy.

Zadig - Science and Health Communication, Milan, Italy.

出版信息

BMC Cancer. 2017 Jun 19;17(1):429. doi: 10.1186/s12885-017-3428-9.

Abstract

BACKGROUND

In Italy women aged 50-69 are invited for a population-based breast cancer (BC) screening. Physicians, policy makers and patients associations agree on the need to inform women about the benefits and harms in order to permit an informed decision. Decision aids (DA) are an effective way to support people in their decisions about health. This trial aims to assess women's informed choices, according to their health literacy and values, on participating or not in BC screening for the first time. Benefits, harms and controversies are presented.

METHODS/DESIGN: The impact of the DA will be evaluated in a randomized controlled trial with a two-week follow-up. Women will be randomized via web to DA or a standard brochure. We will invite 8160 women, to obtain a final sample of 816 women. The primary outcome will be informed choice, measured on the basis of knowledge, attitudes and intentions on BC screening. Secondary outcomes are participation rate, satisfaction on information and decisional conflict.

DISCUSSION

The web DA will be open-source and implemented on BC screenings and its efficacy for increasing informed choice will be tested. This model could be applied to other healthcare settings, cancer screenings, and public health programs.

TRIAL REGISTRATION

The protocol for this trial was registered with the Clinicaltrials.gov registry on March 16, 2017: NCT03097653 .

摘要

背景

在意大利,年龄在50至69岁的女性会被邀请参加基于人群的乳腺癌筛查。医生、政策制定者和患者协会都认同有必要让女性了解筛查的益处和风险,以便她们能做出明智的决定。决策辅助工具是帮助人们做出健康决策的有效方式。本试验旨在根据女性的健康素养和价值观,评估她们首次参与或不参与乳腺癌筛查的明智选择。同时还会介绍筛查的益处、风险及争议。

方法/设计:将在一项为期两周随访的随机对照试验中评估决策辅助工具的效果。女性将通过网络随机分为接受决策辅助工具组或标准宣传册组。我们将邀请8160名女性,最终样本量为816名女性。主要结局指标是明智选择,根据对乳腺癌筛查的知识、态度和意愿来衡量。次要结局指标包括参与率、对信息的满意度和决策冲突。

讨论

网络决策辅助工具将是开源的,并应用于乳腺癌筛查,其增加明智选择的效果将得到检验。该模式可应用于其他医疗保健领域、癌症筛查和公共卫生项目。

试验注册

本试验方案于2017年3月16日在Clinicaltrials.gov注册:NCT03097653 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/612c/5477267/dc881ec4ebe1/12885_2017_3428_Fig1_HTML.jpg

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