教育干预对女性医疗保健提供者关于乳腺癌风险模型使用和高风险筛查建议知识差距的影响。

Effect of an Educational Intervention on Women's Health Care Provider Knowledge Gaps About Breast Cancer Risk Model Use and High-risk Screening Recommendations.

机构信息

DenseBreast-info, Inc, Deer Park, NY, USA.

University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Department of Radiology, Pittsburgh, PA, USA.

出版信息

J Breast Imaging. 2023 Feb 6;5(1):30-39. doi: 10.1093/jbi/wbac072.

DOI:10.1093/jbi/wbac072

PMID:38416962

Abstract

OBJECTIVE

To assess effectiveness of a web-based educational intervention on women's health care provider knowledge of breast cancer risk models and high-risk screening recommendations.

METHODS

A web-based pre- and post-test study including 177 U.S.-based women's health care providers was conducted in 2019. Knowledge gaps were defined as fewer than 75% of respondents answering correctly. Pre- and post-test knowledge differences (McNemar test) and associations of baseline characteristics with pre-test knowledge gaps (logistic regression) were evaluated.

RESULTS

Respondents included 131/177 (74.0%) physicians; 127/177 (71.8%) practiced obstetrics/gynecology. Pre-test, 118/177 (66.7%) knew the Gail model predicts lifetime invasive breast cancer risk; this knowledge gap persisted post-test [(121/177, 68.4%); P = 0.77]. Just 39.0% (69/177) knew the Gail model identifies women eligible for risk-reducing medications; this knowledge gap resolved. Only 48.6% (86/177) knew the Gail model should not be used to identify women meeting high-risk MRI screening guidelines; this deficiency decreased to 66.1% (117/177) post-test (P = 0.001). Pre-test, 47.5% (84/177) knew the Tyrer-Cuzick model is used to identify women meeting high-risk screening MRI criteria, 42.9% (76/177) to predict BRCA1/2 pathogenic mutation risk, and 26.0% (46/177) to predict lifetime invasive breast cancer risk. These knowledge gaps persisted but improved. For a high-risk 30-year-old, 67.8% (120/177) and 54.2% (96/177) pre-test knew screening MRI and mammography/tomosynthesis are recommended, respectively; 19.2% (34/177) knew both are recommended; and 53% (94/177) knew US is not recommended. These knowledge gaps resolved or reduced.

CONCLUSION

Web-based education can reduce important provider knowledge gaps about breast cancer risk models and high-risk screening recommendations.

摘要

目的

评估基于网络的教育干预措施对女性健康护理提供者乳腺癌风险模型和高危筛查建议知识的有效性。

方法

2019 年进行了一项基于网络的预-后测试研究，包括 177 名美国女性健康护理提供者。知识差距定义为少于 75%的受访者回答正确。评估了预-后测试知识差异（McNemar 检验）以及基线特征与预测试知识差距的关联（逻辑回归）。

结果

受访者包括 131/177（74.0%）名医生；127/177（71.8%）名医生从事妇产科工作。在预测试中，118/177（66.7%）名参与者知道 Gail 模型预测终生浸润性乳腺癌风险；这一知识差距在测试后仍然存在[（121/177，68.4%）；P=0.77]。只有 39.0%（69/177）名参与者知道 Gail 模型可识别适合使用降低风险药物的女性；这一知识差距得到了解决。只有 48.6%（86/177）名参与者知道 Gail 模型不应用于识别符合高危 MRI 筛查指南的女性；这一缺陷在测试后减少到 66.1%（117/177）（P=0.001）。在预测试中，47.5%（84/177）名参与者知道 Tyrer-Cuzick 模型用于识别符合高危筛查 MRI 标准的女性，42.9%（76/177）名参与者知道预测 BRCA1/2 致病性突变风险，26.0%（46/177）名参与者知道预测终生浸润性乳腺癌风险。这些知识差距仍然存在，但有所改善。对于一位高危 30 岁女性，67.8%（120/177）和 54.2%（96/177）名参与者在预测试中分别知道推荐进行筛查 MRI 和乳房 X 线断层合成术；19.2%（34/177）名参与者知道两者均推荐；53%（94/177）名参与者知道不推荐使用 US。这些知识差距得到解决或缩小。