对比增强乳腺 X 线摄影与 MRI 作为乳腺癌补充筛查选择的患者偏好的层次分析法分析。
Analytic Hierarchy Process Analysis of Patient Preferences for Contrast-Enhanced Mammography Versus MRI as Supplemental Screening Options for Breast Cancer.
机构信息
Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania; ACR and the Society of Breast Imaging, Honorary Fellow of the Austrian Roentgen Society, and voluntary Chief Scientific Advisor to DenseBreast-info website.
Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
出版信息
J Am Coll Radiol. 2023 Aug;20(8):758-768. doi: 10.1016/j.jacr.2023.05.014. Epub 2023 Jun 30.
OBJECTIVE
To guide implementation of supplemental breast screening by assessing patient preferences for contrast-enhanced mammography (CEM) versus MRI using analytic hierarchy process (AHP) methodology.
METHODS
In an institutional review board-approved, HIPAA-compliant protocol, from March 23 to June 3, 2022, we contacted 579 women who had both CEM screening and MRI. Women were e-mailed an invitation to complete an online survey developed using an AHP-based model to elicit preferences for CEM or MRI. Methods for categorical data analysis were used to evaluate factors affecting preferences, under the Bonferroni correction for multiplicity.
RESULTS
Complete responses were received from 222 (38.3%) women; the 189 women with a personal history of breast cancer had a mean age 61.8 years, and the 34 women without a personal history of breast cancer had a mean age of 53.6 years. Of 222 respondents, 157 (70.7%, confidence interval [CI]: 64.7-76.7) were determined to prefer CEM to MRI. Breast positioning was the most important criterion for 74 of 222 (33.3%) respondents, with claustrophobia, intravenous line placement, and overall stress most important for 38, 37, and 39 women (17.1%, 16.7%, and 17.6%), respectively, and noise level, contrast injection, and indifference being emphasized least frequently (by 10 [4.5%], 11 [5.0%], and 13 [5.9%] women, respectively). CEM preference was most prevalent (MRI least prevalent) for respondents emphasizing claustrophobia (37 of 38 [97%], CI: 86.2-99.9); CEM preference was least prevalent (MRI most prevalent) for respondents emphasizing breast positioning (40 of 74 [54%], CI: 42.1-65.7).
CONCLUSIONS
AHP-based modeling reveals strong patient preferences for CEM over MRI, with claustrophobia favoring preference for CEM and breast positioning relatively favoring preference for MRI. Our results should help guide implementation of screening CEM and MRI.
目的
通过使用层次分析法（AHP）评估患者对对比增强乳腺摄影（CEM）与 MRI 的偏好，指导补充乳腺筛查的实施。
方法
在机构审查委员会批准、符合 HIPAA 规定的协议下，于 2022 年 3 月 23 日至 6 月 3 日，我们联系了 579 名同时接受 CEM 筛查和 MRI 的女性。通过使用基于 AHP 的模型开发的在线调查，向女性发送电子邮件邀请，以获得对 CEM 或 MRI 的偏好。使用分类数据分析方法，在 Bonferroni 多重校正下评估影响偏好的因素。
结果
共收到 222 名（38.3%）女性的完整回复；189 名有乳腺癌个人病史的女性平均年龄为 61.8 岁，34 名无乳腺癌个人病史的女性平均年龄为 53.6 岁。在 222 名受访者中，有 157 名（70.7%，置信区间 [CI]：64.7-76.7）表示更倾向于 CEM 而非 MRI。对于 222 名受访者中的 74 名（33.3%），乳房定位是最重要的标准，38 名、37 名和 39 名女性（17.1%、16.7%和 17.6%）认为幽闭恐惧症、静脉置管和总体压力最重要，而噪声水平、造影剂注射和漠不关心的受访者则相对较少（分别为 10 名[4.5%]、11 名[5.0%]和 13 名[5.9%]）。对于强调幽闭恐惧症的受访者（38 名中的 37 名[97%]，CI：86.2-99.9），CEM 的偏好最为普遍（MRI 的偏好最少）；对于强调乳房定位的受访者（74 名中的 40 名[54%]，CI：42.1-65.7），CEM 的偏好则最少（MRI 的偏好最多）。
结论
基于 AHP 的模型揭示了患者对 CEM 比对 MRI 的强烈偏好，幽闭恐惧症倾向于选择 CEM，而乳房定位则相对倾向于选择 MRI。我们的研究结果应有助于指导实施 CEM 和 MRI 的筛查。
Zotero 插件