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血液系统恶性肿瘤决策辅助工具的系统评价:目前有哪些可用的,我们还缺少哪些?

A Systematic Review of Decision Aids in Hematologic Malignancies: What Are Currently Available and What Are We Missing?

机构信息

Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.

Section of Hematology and Medical Oncology, Boston University School of Medicine, Boston, MA, USA.

出版信息

Oncologist. 2023 Feb 8;28(2):105-115. doi: 10.1093/oncolo/oyac231.

Abstract

BACKGROUND

Patient decision aids (PDAs) are tools designed to facilitate decision-making. In this systematic review, we summarized existing studies on the development and evaluation of PDAs for patients with hematologic malignancies.

PATIENTS AND METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for articles in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. We included studies, abstracts, and clinical trial protocols available in English involving PDAs for patients age ≥18 diagnosed with a hematologic malignancy and/or their caregivers. Data were summarized using descriptive statistics.

RESULTS

Of the 5281 titles/abstracts screened, 15 were included: 1 protocol, 7 abstracts, and 7 full-texts. Six were PDA developmental studies, 6 were pilot studies, and 3 were randomized trials. PDA formats included electronic with web content, videos, and/or audio, questionnaires, bedside instruments, and a combination of various formats. Average participant age ranged from 36.0 to 62.4 years. Patients and caregivers identified efficacy, adverse effects, cost, and quality of life as important decision-making factors. PDAs were associated with increased knowledge and patient satisfaction as well as decreased decisional conflict and attitudinal barriers. Research on PDAs for adult patients with hematologic malignancies and their caregivers is limited. Among the studies, PDAs appear to support patients in shared decision-making.

CONCLUSION

While current literature examining the use of PDAs for adults with hematologic malignancies is limited, the positive impact of PDAs on shared decision-making and patient outcomes warrants additional research in this field.

摘要

背景

患者决策辅助工具(PDAs)是旨在促进决策制定的工具。在本次系统评价中,我们总结了现有关于血液恶性肿瘤患者 PDAs 开发和评估的研究。

患者和方法

我们遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南。我们在 PubMed、Embase、Web of Science、Cochrane 对照试验中心注册库和 ClinicalTrials.gov 中搜索文章。我们纳入了研究、摘要和临床试验方案,这些研究和方案以英文发表,涉及年龄≥18 岁被诊断为血液恶性肿瘤和/或其照护者的患者使用 PDAs。使用描述性统计方法汇总数据。

结果

在筛选出的 5281 篇标题/摘要中,有 15 篇被纳入:1 项方案、7 篇摘要和 7 篇全文。其中 6 项为 PDAs 开发研究、6 项为试点研究、3 项为随机试验。PDAs 格式包括带网页内容、视频和/或音频的电子、问卷、床边仪器以及各种格式的组合。参与者的平均年龄范围为 36.0 至 62.4 岁。患者和照护者将疗效、不良反应、成本和生活质量确定为重要的决策因素。PDAs 与增加知识和患者满意度以及减少决策冲突和态度障碍相关。关于血液恶性肿瘤成年患者及其照护者使用 PDAs 的研究有限。在这些研究中,PDAs 似乎支持患者进行共同决策。

结论

虽然目前关于血液恶性肿瘤成年患者使用 PDAs 的文献有限,但 PDAs 对共同决策和患者结局的积极影响需要在该领域进行更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c43/9907042/9ccb096ae919/oyac231f0001.jpg

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