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探索 MAPPING 应用程序,以促进妇科癌症患者与医生之间的风险沟通和共同决策。

Exploring the MAPPING application to facilitate risk communication and shared decision-making between physicians and patients with gynaecological cancer.

机构信息

Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, The Netherlands.

Centre for Gynecological Oncology Amsterdam (CGOA), Amsterdam, The Netherlands.

出版信息

BMJ Open Qual. 2024 Aug 19;13(3):e002776. doi: 10.1136/bmjoq-2024-002776.

DOI:10.1136/bmjoq-2024-002776
PMID:39160112
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11337712/
Abstract

This is an observational study in which we evaluated current levels of risk communication (RC) among gynaecological oncologists and their view on the Mapping All Patient Probabilities in Numerical Graphs (MAPPING) application as a possible tool to facilitate RC and shared decision-making (SDM). In part A, we audio-recorded 29 conversations between gynaecological oncologists and patients when discussing treatment options. In part B, interviews were performed with eight gynaecological oncologists.RC and SDM were measured using two observer-based measures, that is, the RC content (RCC) tool (scale 0-2) and the OPTION-5 instrument (scale 0-100). We used CollaboRATE questionnaire (scale 0-10) and a self-developed survey to assess patient-reported RC and SDM. In part B, we evaluated physicians' attitudes regarding the use of the MAPPING application to support RC. Patients were minimally involved in the decision-making process (OPTION-5 25.9%±13.4 RCC 0.21±0.18). Patient-reported SDM was high (mean collaboRATE score 9.19±1.79) and patients preferred receiving numeric information, whereas most physicians used qualitative risk terms rather than exact numbers. In part B, gynaecologists had a positive attitude towards the MAPPING application. However, they stated that the app was difficult to use improvement of layout and better implementations are needed.

摘要

这是一项观察性研究,旨在评估妇科肿瘤学家当前的风险沟通(RC)水平,以及他们对映射所有患者概率数值图(MAPPING)应用程序作为促进 RC 和共享决策(SDM)的可能工具的看法。在 A 部分,我们对 29 名妇科肿瘤学家与患者讨论治疗方案时的对话进行了录音。在 B 部分,对 8 名妇科肿瘤学家进行了访谈。RC 和 SDM 采用两种基于观察者的测量方法进行测量,即 RC 内容(RCC)工具(量表 0-2)和 OPTION-5 仪器(量表 0-100)。我们使用了 CollaboRATE 问卷(量表 0-10)和自行开发的调查来评估患者报告的 RC 和 SDM。在 B 部分,我们评估了医生对使用 MAPPING 应用程序支持 RC 的态度。患者在决策过程中的参与度很低(OPTION-5 为 25.9%±13.4,RCC 为 0.21±0.18)。患者报告的 SDM 很高(CollaboRATE 平均得分为 9.19±1.79),且更喜欢接收数字信息,而大多数医生使用定性风险术语而不是确切数字。在 B 部分,妇科肿瘤学家对 MAPPING 应用程序持积极态度。然而,他们表示该应用程序使用困难,需要改进布局和更好的实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2513/11337712/57c9d713f6d1/bmjoq-13-3-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2513/11337712/a31324b7526c/bmjoq-13-3-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2513/11337712/57c9d713f6d1/bmjoq-13-3-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2513/11337712/a31324b7526c/bmjoq-13-3-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2513/11337712/57c9d713f6d1/bmjoq-13-3-g002.jpg

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Evaluate the effectiveness of breast cancer decision aids: A systematic review and meta-analysis of randomize clinical trails.评估乳腺癌决策辅助工具的有效性:随机临床试验的系统评价和荟萃分析。
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