Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands; Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands.
Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
Urol Oncol. 2019 Jul;37(7):409-429. doi: 10.1016/j.urolonc.2019.04.005. Epub 2019 Apr 30.
Despite increasing interest in the development and use of decision aids (DAs) for patients with localized prostate cancer (LPC), little attention has been paid to communicative aspects (CAs) of such tools.
To identify DAs for LPC treatment, and review these tools for various CAs.
DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO; 1990-2018) and online sources, in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Identified DAs were reviewed for the International Patient Decision Aid Standards criteria, and analyzed on CAs, including information presentation, personalization, interaction, information control, accessibility, suitability, and source of information. Nineteen DAs were identified.
International Patient Decision Aid Standards scores varied greatly among DAs. Crucially, substantial variations in use of CAs by DAs were identified: (1) few DAs used visual aids to communicate statistical information, (2) none were personalized in terms of outcome probabilities or mode of communication, (3) a minority used interactive methods to elicit patients' values and preferences, (4) most included biased cross tables to compare treatment options, and (5) issues were observed in suitability and accessibility that could hinder implementation in clinical practice.
Our review suggests that DAs for LPC treatment could be further improved by adding CAs such as personalized outcome predictions and interaction methods to the DAs. Clinicians who are using or developing such tools might therefore consider these CAs in order to enhance patient participation in treatment decision-making.
尽管人们对开发和使用针对局限性前列腺癌（LPC）患者的决策辅助工具（DAs）越来越感兴趣，但对这些工具的交流方面（CAs）却关注甚少。
确定用于 LPC 治疗的 DAs，并对这些工具的各种 CAs 进行回顾。
通过已发表的文献（MEDLINE、Embase、CINAHL、CENTRAL 和 PsycINFO；1990-2018 年）和在线资源，按照系统评价和荟萃分析的首选报告项目的规定，确定 DAs。对确定的 DAs 进行国际患者决策辅助工具标准的评估，并根据 CAs 进行分析，包括信息呈现、个性化、交互、信息控制、可及性、适用性和信息来源。共确定了 19 个 DAs。
DAs 的国际患者决策辅助工具标准评分差异很大。至关重要的是，DAs 在 CAs 的使用上存在很大差异：（1）很少有 DAs 使用视觉辅助工具来传达统计信息，（2）在结果概率或沟通模式方面没有个性化，（3）少数使用互动方法来引出患者的价值观和偏好，（4）大多数包括有偏差的交叉表来比较治疗方案，（5）在适用性和可及性方面存在问题，这可能会阻碍其在临床实践中的实施。
我们的回顾表明，通过在 DAs 中添加 CAs，如个性化的结果预测和互动方法，可以进一步改进用于 LPC 治疗的 DAs。因此，使用或开发此类工具的临床医生可能会考虑这些 CAs，以增强患者在治疗决策中的参与度。
