Sundaresan Puma, Ager Brittany, Turner Sandra, Costa Dan, Kneebone Andrew, Pearse Maria, Woo Henry, Tesson Stephanie, Juraskova Ilona, Butow Phyllis
Sydney Medical School, University of Sydney, Australia; Radiation Oncology Network, Westmead Hospital, NSW, Australia.
Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Australia.
Radiother Oncol. 2017 Oct;125(1):124-129. doi: 10.1016/j.radonc.2017.08.013. Epub 2017 Aug 23.
Randomised controlled trials (RCTs) are considered the 'gold-standard' for evaluating medical treatments. However, patients and clinicians report difficulties with informed consent and recruitment. We evaluated the utility of a Decision Aid (DA) in reducing RCT-related decisional conflict, and improving RCT knowledge and recruitment.
Potential participants for a radiotherapy RCT were invited to participate in the current study. Participants were randomised to receive the RCT's participant information sheet with or without a DA. Questionnaires were administered at baseline, one and six months. The primary outcome measure was decisional conflict. Secondary outcome measures included knowledge regarding and recruitment to the RCT.
129 men were randomised to the DA (63) and control (66) arms. Decisional conflict was significantly lower over 6-months (p=0.048) in the DA arm. Knowledge regarding the RCT was significantly higher at 6months (p=0.033) in the DA arm. 20.6% of the DA arm (13 of 63) and 9% of the control arm (6 of 66) entered the RCT.
This study demonstrates the utility of a DA in reducing decisional conflict and improving trial knowledge in men with cancer who are making decisions regarding RCT participation.
随机对照试验(RCT)被视为评估医学治疗方法的“金标准”。然而,患者和临床医生表示在知情同意和招募方面存在困难。我们评估了决策辅助工具(DA)在减少与RCT相关的决策冲突以及提高RCT知识和招募率方面的效用。
邀请一项放射治疗RCT的潜在参与者参加本研究。参与者被随机分为两组,分别接受带有或不带有DA的RCT参与者信息表。在基线、1个月和6个月时进行问卷调查。主要结局指标是决策冲突。次要结局指标包括对RCT的了解程度和参与RCT的情况。
129名男性被随机分为DA组(63人)和对照组(66人)。DA组在6个月内的决策冲突显著较低(p = 0.048)。DA组在6个月时对RCT的了解程度显著更高(p = 0.033)。DA组的20.6%(63人中的13人)和对照组的9%(66人中的6人)进入了RCT。
本研究证明了DA在减少正在就参与RCT做出决策的癌症男性的决策冲突和提高试验知识方面的效用。