Centre for Cancer Research, Department of General Practice, University of Melbourne, Melbourne, Australia.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Br J Gen Pract. 2019 Nov 28;69(689):e843-e849. doi: 10.3399/bjgp19X706613. Print 2019 Dec.
New Australian guidelines recommend that GPs actively consider prescribing low-dose aspirin to patients aged 50-70 years to reduce their risk of developing colorectal cancer (CRC). Patients and GPs need to understand the relative benefits and harms to support informed decision making.
To develop and examine different methods to communicate the benefits and harms of taking aspirin for CRC prevention.
A cross-sectional, vignette study with patients aged 50-70 years consecutively recruited from general practices in Melbourne, Australia, between July and August 2018.
Summary estimates from meta-analyses of the effects of aspirin on the incidence of CRC, cardiovascular disease, gastrointestinal bleeding, and incidence rates in the Australian population to estimate outcomes in a hypothetical population of 10 000 people aged 50-70 years. These estimates were presented using four different risk communication formats. Participants were shown these different formats and asked if they would take aspirin to prevent CRC.
A total of 313 participants were recruited (95.1% recruitment rate), of whom 304 completed the study. Most participants (71.7-75.3%) reported they would take aspirin irrespective of risk format presented. Bar charts (odds ratio [OR] 1.20, 95% confidence intervals [CI] = 1.01 to 1.44) and expected frequency trees (OR 1.18, 95% CI = 0.99 to 1.41) were more strongly associated with the intentions to take aspirin compared with icon arrays. Bar charts were most preferred for presenting risk information.
A large proportion of participants in this study intended to take aspirin to reduce their CRC risk regardless of risk communication format. Bar charts and expected frequency trees were the preferred methods to present the benefits and harms of taking aspirin to prevent CRC.
新的澳大利亚指南建议全科医生积极考虑为 50-70 岁的患者开低剂量阿司匹林，以降低他们患结直肠癌（CRC）的风险。患者和全科医生需要了解相对的益处和危害，以支持知情决策。
开发和检验不同的方法来传达服用阿司匹林预防 CRC 的益处和危害。
这是一项在澳大利亚墨尔本的普通诊所招募 50-70 岁患者的横断面、病例系列研究，招募时间为 2018 年 7 月至 8 月。
使用荟萃分析的汇总估计数，评估阿司匹林对 CRC、心血管疾病、胃肠道出血和澳大利亚人群发病率的影响，以估计在一个假设的 10000 名 50-70 岁人群中的结果。这些估计数使用四种不同的风险沟通格式呈现。向参与者展示这些不同的格式，并询问他们是否会服用阿司匹林来预防 CRC。
共招募了 313 名参与者（招募率为 95.1%），其中 304 名完成了研究。大多数参与者（71.7-75.3%）表示无论呈现何种风险格式，他们都会服用阿司匹林。条形图（比值比 [OR] 1.20，95%置信区间 [CI] = 1.01 至 1.44）和预期频率树（OR 1.18，95%CI = 0.99 至 1.41）与服用阿司匹林的意图更相关，而图标数组则不然。条形图是呈现风险信息的首选方法。
在这项研究中，很大一部分参与者无论风险沟通格式如何，都打算服用阿司匹林来降低他们的 CRC 风险。条形图和预期频率树是呈现服用阿司匹林预防 CRC 的益处和危害的首选方法。
