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研究结构可能会影响对纵向决策后悔稳定性的理解:系统评价。

Study structure may compromise understanding of longitudinal decision regret stability: A systematic review.

机构信息

Department of Systems Engineering and Operations Research, George Mason University, Fairfax, Virginia, USA.

出版信息

Patient Educ Couns. 2020 Aug;103(8):1507-1517. doi: 10.1016/j.pec.2020.03.011. Epub 2020 Mar 12.

Abstract

OBJECTIVES

To perform a systematic review of decision regret studies in cancer patients to determine if regret is longitudinally stable, and whether these study structures account for late-emerging treatment effects.

METHODS

Online databases including the George Mason Libraries, Global Health, Nursing and Allied Health, and PubMed were searched to identify decision regret studies with longitudinal components in patients with cancer.

RESULTS

A total of 845 unique citations were identified; 20 studies met inclusion criteria. Data was also collected on the time horizon for 90 studies; 47 % of studies evaluated regret at time points of one year or less, although this has increased significantly in prostate cancer citations since 2010. Regret was infrequent, affecting less than 20 % of patients, and often stable. Effect sizes in studies where decision regret changed over time were small to negligible.

CONCLUSION

Longitudinal effects can influence the expression of decision regret, yet many studies are not designed to collect long-term data; prostate cancer studies may be particularly disadvantaged. The degree of this influence in current studies is small, though this outcome must be interpreted with caution.

PRACTICE IMPLICATIONS

Providers should be aware of the risk of late-emerging regret and counsel patients appropriately.

摘要

目的

对癌症患者的决策后悔研究进行系统回顾,以确定后悔是否具有纵向稳定性,以及这些研究结构是否可以解释后期出现的治疗效果。

方法

在乔治梅森大学图书馆、全球健康、护理和相关健康以及 PubMed 等在线数据库中进行搜索,以确定具有纵向成分的癌症患者决策后悔研究。

结果

共确定了 845 条独特的引用文献;20 项研究符合纳入标准。还收集了 90 项研究的时间范围数据;47%的研究在一年或更短的时间内评估了后悔,尽管自 2010 年以来,前列腺癌引用文献中这一比例显著增加。后悔的发生率较低,不到 20%的患者感到后悔,且往往是稳定的。在后悔随时间变化的研究中,效应大小较小或可以忽略不计。

结论

纵向效应可能会影响决策后悔的表达,但许多研究并未设计用于收集长期数据;前列腺癌研究可能特别处于不利地位。目前研究中这种影响的程度很小,但必须谨慎解释这一结果。

实践意义

提供者应该意识到后期出现后悔的风险,并适当为患者提供咨询。

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