基于网络的前列腺癌筛查知情决策辅助工具的开发和初步评估。

A Web-Based Decision Aid for Informed Prostate Cancer Screening: Development and Pilot Evaluation.

机构信息

Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Korea.

Department of Medicine, School of Medicine, Sungkyunkwan University, Seoul, Korea.

出版信息

J Korean Med Sci. 2023 Nov 27;38(46):e360. doi: 10.3346/jkms.2023.38.e360.

DOI:10.3346/jkms.2023.38.e360

PMID:38013645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10681842/

Abstract

BACKGROUND

Prostate-specific antigen-based routine screening is not recommended for the general population due to conflicting results with mortality reduction. We aimed to develop a web-based decision aid (DA) for informed decision making for prostate cancer screening.

METHODS

Using the International Patient Decision Aid Standards (IPDAS) development process model, we developed our DA based on patient and clinician interviews and multidisciplinary expert discussions. The prototype consisted of predicting individual prostate cancer risk and informed decision-making, including knowledge, risk and benefit, cost, personal value, and decision making. We conducted a pilot study on 101 healthy men, evaluating the effectiveness of DA by measuring knowledge, attitude, and intention to screen before and after using the DA, as well as decisional conflict and usefulness after using the DA.

RESULTS

Of the 101 participants (median age 60 [50-69] years), 84% had not undergone screening for prostate cancer in the past two years. After using the DA, knowledge on prostate cancer screening increased (mean score [of 10] before versus after: 6.85 ± 1.03 versus 7.57 ± 1.25; < 0.001), and intention to not screen increased from 27.7% to 51.5% ( < 0.001), but attitude toward screening did not change ( = 0.564). After use of the DA, 79 participants reported no decisional conflict, and the usefulness score was high (mean score [of 100] 77.35 ± 7.69), with 85% of participants reporting that the DA helped with decision making.

CONCLUSION

Our web-based DA yielded increased knowledge, decreased screening intention, and high perceived usefulness. These findings indicate potential clinical relevance, especially among younger individuals.

摘要

背景

由于与死亡率降低相关的结果存在冲突，不建议对一般人群进行基于前列腺特异性抗原的常规筛查。我们旨在开发一种基于网络的决策辅助工具（DA），以帮助人们做出明智的前列腺癌筛查决策。

方法

我们使用国际患者决策辅助标准（IPDAS）开发过程模型，根据患者和临床医生的访谈以及多学科专家讨论来开发我们的 DA。原型包括预测个体前列腺癌风险和知情决策，包括知识、风险和益处、成本、个人价值观和决策。我们对 101 名健康男性进行了一项试点研究，通过测量使用 DA 前后的知识、态度和筛查意愿，以及使用 DA 后的决策冲突和有用性，来评估 DA 的有效性。

结果

在 101 名参与者中（中位年龄 60 [50-69] 岁），84%的人在过去两年内没有进行过前列腺癌筛查。使用 DA 后，对前列腺癌筛查的了解有所增加（平均得分[十分制]：使用前 6.85 ± 1.03，使用后 7.57 ± 1.25；<0.001），不筛查的意愿从 27.7%增加到 51.5%（<0.001），但对筛查的态度没有改变（=0.564）。使用 DA 后，79 名参与者报告没有决策冲突，并且有用性评分较高（平均得分[百分制]：77.35 ± 7.69），85%的参与者报告 DA 有助于决策。