Johns Hopkins School of Medicine, Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 725, Baltimore, MD, 21205, USA.
Qual Life Res. 2019 Mar;28(3):609-620. doi: 10.1007/s11136-018-2065-3. Epub 2018 Nov 29.
PURPOSE: Patient-reported outcome (PRO) data from clinical trials can promote valuable patient-clinician communication and aid the decision-making process regarding treatment options. Despite these benefits, both patients and doctors face challenges in interpreting PRO scores. The purpose of this study was to identify best practices for presenting PRO results expressed as proportions of patients with changes from baseline (improved/stable/worsened) for use in patient educational materials and decision aids. METHODS: We electronically surveyed adult cancer patients/survivors, oncology clinicians, and PRO researchers, and conducted one-on-one cognitive interviews with patients/survivors and clinicians. Participants saw clinical trial data comparing two treatments as proportions changed using three different formats: pie charts, bar graphs, icon arrays. Interpretation accuracy, clarity, and format preference were analyzed quantitatively and online survey comments and interviews, qualitatively. RESULTS: The internet sample included 629 patients, 139 clinicians, and 249 researchers; 10 patients and 5 clinicians completed interviews. Bar graphs were less accurately interpreted than pie charts (OR 0.39; p < .0001) and icon arrays (OR 0.47; p < .0001). Bar graphs and icon arrays were less likely to be rated clear than pie charts (OR 0.37 and OR 0.18; both p < .0001). Qualitative data informed interpretation of these findings. CONCLUSIONS: For communicating PROs as proportions changed in patient educational materials and decision aids, these results support the use of pie charts.
目的:临床试验中的患者报告结局(PRO)数据可以促进有价值的医患沟通,并有助于治疗选择的决策过程。尽管有这些好处,但患者和医生在解释 PRO 评分时都面临挑战。本研究旨在确定将 PRO 结果表示为从基线变化的患者比例(改善/稳定/恶化)呈现给患者教育材料和决策辅助工具的最佳实践。
方法:我们通过电子方式调查了成年癌症患者/幸存者、肿瘤学临床医生和 PRO 研究人员,并对患者/幸存者和临床医生进行了一对一的认知访谈。参与者查看了比较两种治疗方法的临床试验数据,这些数据以三种不同的格式表示为比例变化:饼图、柱状图、图标数组。对解释的准确性、清晰度和格式偏好进行了定量分析,并对在线调查评论和访谈进行了定性分析。
结果:互联网样本包括 629 名患者、139 名临床医生和 249 名研究人员;10 名患者和 5 名临床医生完成了访谈。与饼图相比,柱状图的解释准确性较低(OR 0.39;p<0.0001)和图标数组(OR 0.47;p<0.0001)。与饼图相比,柱状图和图标数组更不容易被评为清晰(OR 0.37 和 OR 0.18;均 p<0.0001)。定性数据为这些发现的解释提供了信息。
结论:对于在患者教育材料和决策辅助工具中传达 PRO 作为比例变化的情况,这些结果支持使用饼图。
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