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评估一种支持患者选择移植中心的新工具的随机对照试验。

Randomized Controlled Trial to Evaluate a New Tool to Support Patient Decision-making on Transplant Centers.

作者信息

McKinney Warren T, Israni Kareena, Schaffhausen Cory R, Schladt David P, Lyden Grace R, Matas Arthur, Wolf Jack, Japuntich Sandra, Israni Ajay K

机构信息

Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.

Division of Nephrology, Hennepin Healthcare, Minneapolis, Minnesota, USA.

出版信息

Clin Transplant. 2024 Dec;38(12):e70043. doi: 10.1111/ctr.70043.

Abstract

Patients are not always aware of listing criteria and offer acceptance across transplant programs. Factors such as age and body mass index can impact access to transplants as centers have different candidate criteria. Therefore, we created a transplant center search tool (transplantcentersearch.org) (TCST) to help patients find comparative information on transplant programs. We conducted a cross-over randomized controlled trial (RCT) to assess whether the TCST improved comprehension compared to the existing Scientific Registry of Transplant Recipients website among adults seeking kidney transplants at two centers. To assess comprehension participants were asked to use the TCST and the SRTR website to identify which transplant program within a prespecified area had the most recipients over 70 years of age; and which programs had the most recipients with BMI >40. Participants were asked to provide qualitative feedback on using both websites. Sixty-eight candidates participated in the RCT. Participants were more likely to identify the correct program when using the TCST compared to the existing SRTR website (OR 8.13, 95% CI 1.87-35.33). Participants stated they preferred the TCST over the SRTR website (52.9% vs. 25.0%, respectively, p = 0.009). With increased comprehension, patients would be better equipped to identify programs that transplant patients like them. Trial Registration: ClinicalTrials.gov identifier: NCT03610555.

摘要

患者并不总是了解各移植项目的列入标准和接受情况。年龄和体重指数等因素会影响移植机会,因为不同的移植中心有不同的候选标准。因此,我们创建了一个移植中心搜索工具(transplantcentersearch.org)(TCST),以帮助患者查找有关移植项目的比较信息。我们进行了一项交叉随机对照试验(RCT),以评估与现有的移植受者科学登记网站相比,TCST是否能提高在两个中心寻求肾移植的成年人的理解能力。为了评估理解能力,我们要求参与者使用TCST和SRTR网站,确定在一个预先指定的区域内,哪个移植项目的70岁以上受者最多;以及哪个项目的体重指数>40的受者最多。我们要求参与者对使用这两个网站提供定性反馈。68名候选人参与了RCT。与现有的SRTR网站相比,参与者使用TCST时更有可能识别出正确的项目(优势比8.13,95%置信区间1.87 - 35.33)。参与者表示,他们更喜欢TCST而不是SRTR网站(分别为52.9%对25.0%,p = 0.009)。随着理解能力的提高,患者将更有能力识别适合像他们这样的患者进行移植的项目。试验注册:ClinicalTrials.gov标识符:NCT03610555。

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本文引用的文献

1
OPTN/SRTR 2022 Annual Data Report: Kidney.OPTN/SRTR 2022 年度数据报告:肾脏。
Am J Transplant. 2024 Feb;24(2S1):S19-S118. doi: 10.1016/j.ajt.2024.01.012.

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