Development and Validation of a Personalized, Web-Based Decision Aid for Lung Cancer Screening Using Mixed Methods: A Study Protocol
Development and Validation of a Personalized, Web-Based Decision Aid for Lung Cancer Screening Using Mixed Methods: A Study Protocol
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DOI：
10.2196/resprot.4039
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发表时间：
2014-10-01
影响因子：
1.7
通讯作者：
Meza, Rafael
中科院分区：
文献类型：
--
作者：
Lau, Yan Kwan;Caverly, Tanner J.;Meza, Rafael
背景资料：国家肺筛查试验表明，低剂量计算机断层扫描（LDCT）筛查可能是降低肺癌死亡率的有效方法。在肺癌筛查的背景下，知情的决策要求潜在的筛查对象准确地认识到自己的肺癌风险，以及与筛查相关的危害和益处，同时考虑到他们的个人价值观和偏好。目的：我们的目标是建立一个网络-根据国际患者决策辅助标准工具版本4.0中的资格和认证标准，这将有助于患者作出明智的决定，关于肺癌screen.Methods：在“阿尔法”测试，原型的决策援助进行了测试，与焦点小组的10个潜在的筛选参与者的可用性。还向研究外部的公共卫生和健康风险沟通专家寻求反馈。随后，对原型进行了相应的改进，并以准实验设计的形式进行了“beta”测试-前后研究-有60名参与者。测试的结果是知识，风险认知的肺癌和肺癌筛查，决策冲突，并通过自我管理的电子调查确定的决策援助的可接受性。将对调查参与者的子样本进行焦点小组调查，以进一步了解可用性问题。结果：完成了Alpha测试。目前正在进行Beta测试。截至2014年12月7日，60名参与者完成了前后研究。我们预计将在2015年1月31日公布结果。定性数据的收集和分析预计将于2015年5月31日完成。结论：我们假设，这种基于网络的，互动的决策援助包含个性化的，图形的，背景信息的好处和危害的LDCT筛查将增加知识，减少决策冲突，并提高患者的喜好和目前的美国预防服务工作组的筛查指南之间的一致性。
Background: The National Lung Screening Trial demonstrated that low-dose computed tomography (LDCT) screening could be an effective way to reduce lung cancer mortality. Informed decision-making in the context of lung cancer screening requires that potential screening subjects accurately recognize their own lung cancer risk, as well as the harms and benefits associated with screening, while taking into account their personal values and preferences.Objective: Our objective is to develop a Web-based decision aid in accordance with the qualifying and certification criteria in the International Patient Decision Aid Standards instrument version 4.0 that will assist patients in making informed decisions with regard to lung cancer screening.Methods: In "alpha" testing, a prototype of the decision aid was tested for usability with 10 potential screening participants in focus groups. Feedback was also sought from public health and health risk communication experts external to the study. Following that, improvements to the prototype were made accordingly, and "beta" testing was done in the form of a quasi-experimental design-a before-after study-with a group of 60 participants. Outcomes tested were knowledge, risk perception of lung cancer and lung cancer screening, decisional conflict, and acceptability of the decision aid as determined by means of a self-administered electronic survey. Focus groups of a subsample of survey participants will be conducted to gain further insight into usability issues.Results: Alpha testing is completed. Beta testing is currently being carried out. As of 2014 December 7, 60 participants had completed the before-after study. We expect to have results by 2015 January 31. Qualitative data collection and analysis are expected to be completed by 2015 May 31.Conclusions: We hypothesize that this Web-based, interactive decision aid containing personalized, graphical, and contextual information on the benefits and harms of LDCT screening will increase knowledge, reduce decisional conflict, and improve concordance between patient preferences and the current US Preventive Services Task Force's screening guidelines.