Feufel Markus A, Speiser Dorothee, Schüürhuis Stephen, Neumann Konrad, Keinert Marie, Stegen Steffi, Rauwolf Gudrun, Heibges Maren, Westfal Viola, Besch Laura, Olbrich Christine, Klein Katharina, Witzel Isabell, Kendel Friederike
Division of Ergonomics, Department of Psychology and Ergonomics, Technische Universität Berlin, Berlin, Germany.
Department of Gynecology with Breast Center, Hereditary Breast and Ovarian Cancer Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Genet Med Open. 2024 Sep 6;2(Suppl 2):101892. doi: 10.1016/j.gimo.2024.101892. eCollection 2024.
We developed the online-based counseling tool iKNOW for women with a pathogenic germline variant in to improve risk understanding and quality of life.
With a randomized controlled trial, we investigated the efficacy of iKNOW with regard to risk understanding (primary endpoint), quality of life, risk perception, and anxiety (secondary endpoints). Self-report questionnaires were administered to = 217 women with a pathogenic variant in before counseling (T0), immediately after (T1), 4 weeks after (T2), and 6 months after (T3).
Deviations between self-assessed and calculated cancer risks tended to be smaller in the intervention group than in the control group but no longer significantly after adjustment for multiple testing. In the intervention group, the proportion of women with a correct understanding of breast cancer risk at T3 was higher (30.7% vs 14.7%; = .032). There were no differences in secondary endpoints.
iKNOW tends to positively influence the understanding of familial cancer risk. At the same time, it does not negatively influence any of the secondary endpoints. However, converging evidence suggests that iKNOW seems to affect the quality of counseling processes and can thus be used as a paradigm for reinventing the notion of efficient, digital care.
我们开发了基于网络的咨询工具iKNOW,用于携带致病种系变异的女性,以提高她们对风险的理解和生活质量。
通过一项随机对照试验,我们研究了iKNOW在风险理解(主要终点)、生活质量、风险认知和焦虑(次要终点)方面的疗效。在咨询前(T0)、咨询后立即(T1)、咨询后4周(T2)和咨询后6个月(T3),对217名携带致病变异的女性进行了自我报告问卷调查。
干预组自我评估和计算出的癌症风险之间的偏差往往比对照组小,但在进行多重检验调整后不再具有显著差异。在干预组中,T3时对乳腺癌风险有正确理解的女性比例更高(30.7%对14.7%;P = 0.032)。次要终点方面没有差异。
iKNOW往往会对家族性癌症风险的理解产生积极影响。同时,它不会对任何次要终点产生负面影响。然而,越来越多的证据表明,iKNOW似乎会影响咨询过程的质量,因此可以作为重塑高效数字护理概念的范例。