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低风险浅表性基底细胞癌患者的共同决策质量与决策后悔:一项前瞻性多中心队列研究。

Shared decision-making quality and decisional regret in patients with low-risk superficial basal cell carcinoma: A prospective, multicenter cohort study.

作者信息

Catalan-Griffiths Andrea, Pasquali Paola, Arias-Santiago Salvador, Valeron Pedro, Martinez-Lopez Antonio, Negrin Maria Luz, Thuissard Vasallo Israel John, Andreu-Vazquez Cristina, Freites-Martinez Azael

机构信息

Dermatology Service, Medical University of Graz, Graz, Austria / AUVA Rehabilitation Clinic Tobelbad, Tobelbad, Austria.

Dermatology Service, Pius de Valls Hospital, Tarragona, Spain / Alcala University.

出版信息

JAAD Int. 2023 Jul 11;13:159-163. doi: 10.1016/j.jdin.2023.05.015. eCollection 2023 Dec.

Abstract

BACKGROUND

Many therapies are available to treat low-risk superficial basal cell carcinoma (lr-sBCC), which may complicate the shared decision-making (SDM) process.

OBJECTIVE

To assess the SDM process of patients and physicians when deciding lr-sBCC therapy as well as the factors that may influence the SDM process.

METHODS

A prospective, multicenter cohort study was conducted over 18 months, from October 2018 to April 2020, in 3 tertiary university hospitals and 1 private hospital.

RESULTS

This study included 107 patients. There was a weak positive correlation between Shared Decision-Making Questionnaire-Patient version (SDM-Q-9) and Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) (Spearman's correlation coefficient [] [105] = 0.21;  = .03). Most patients (71%) chose a nonsurgical treatment after the SDM process. Patients with higher satisfaction with the SDM had lower decisional conflict and decisional regret ( < .001). Patients aged >80 years had higher rates of significant decisional conflict. When evaluating treatment decisions, the highest median score for decisional conflict (22, IQR [16];  = .01) was observed among patients who chose a surgical excision.

LIMITATIONS

Patients may have self-selected to participate.

CONCLUSION

This study suggests that some patients may prefer less invasive therapies for lr-sBCC. The SDM process may reduce decisional conflict and decisional regret.

摘要

背景

有多种疗法可用于治疗低风险浅表性基底细胞癌(lr-sBCC),这可能会使共同决策(SDM)过程变得复杂。

目的

评估患者和医生在决定lr-sBCC治疗方案时的SDM过程以及可能影响SDM过程的因素。

方法

2018年10月至2020年4月,在3家三级大学医院和1家私立医院进行了一项为期18个月的前瞻性多中心队列研究。

结果

本研究纳入了107例患者。共同决策问卷-患者版(SDM-Q-9)与共同决策问卷-医生版(SDM-Q-Doc)之间存在弱正相关(Spearman相关系数[] [105] = 0.21; = 0.03)。大多数患者(71%)在SDM过程后选择了非手术治疗。对SDM满意度较高的患者决策冲突和决策遗憾较低(<0.001)。年龄>80岁的患者显著决策冲突发生率较高。在评估治疗决策时,选择手术切除的患者中决策冲突的中位数得分最高(22,四分位间距[16]; = 0.01)。

局限性

患者可能是自行选择参与的。

结论

本研究表明,一些患者可能更喜欢对lr-sBCC采用侵入性较小的疗法。SDM过程可能会减少决策冲突和决策遗憾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388f/10562145/3a728ca0b2a7/gr1.jpg

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