Randomized Trial of Telegenetics vs. In-Person Cancer Genetic Counseling: Cost, Patient Satisfaction and Attendance
Randomized Trial of Telegenetics vs. In-Person Cancer Genetic Counseling: Cost, Patient Satisfaction and Attendance
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DOI：
10.1007/s10897-015-9836-6
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发表时间：
2015-12-01
影响因子：
1.9
通讯作者：
Adams, Martha B.
中科院分区：
文献类型：
--
作者：
Buchanan, Adam H.;Datta, Santanu K.;Adams, Martha B.
远程遗传学-通过现场视频会议进行遗传咨询-可以改善服务不足地区获得癌症遗传咨询（CGC）的机会，但癌症远程遗传学的研究尚未应用随机方法或评估成本。我们报告的成本，病人满意度和CGC出席从一个随机试验比较远程遗传学与个人CGC中提到的CGC在四个农村肿瘤诊所。参与者（n = 162）被随机分配到当地的肿瘤诊所接受CGC治疗或通过远程遗传学进行治疗。成本分析包括远程遗传学系统;里程;和遗传咨询师，IT专家和诊所人员的人员成本。通过研究数据库跟踪CGC出席情况。CGC后1周，通过电话调查使用经验证的量表评估患者满意度。每名远程遗传学患者的总成本为106美元，每名现场患者为244美元。患者满意度在两个满意度量表上均无组间差异。面对面的患者比远程遗传患者更有可能参加CGC（89%对79%，p = 0.03），双变量分析显示计算机舒适度较低和出勤率较低之间存在关联（卡方= 5.49，p = 0.02）。我们对远程遗传学与面对面咨询的随机试验发现，远程遗传学的成本低于面对面咨询，参加者的满意度很高。这项研究为未来的随机试验提供了支持，这些试验比较了多种服务提供模式对长期心理社会和行为结果的影响。
Telegenetics-genetic counseling via live videoconferencing-can improve access to cancer genetic counseling (CGC) in underserved areas, but studies on cancer telegenetics have not applied randomized methodology or assessed cost. We report cost, patient satisfaction and CGC attendance from a randomized trial comparing telegenetics with in-person CGC among individuals referred to CGC in four rural oncology clinics. Participants (n = 162) were randomized to receive CGC at their local oncology clinic in-person or via telegenetics. Cost analyses included telegenetics system; mileage; and personnel costs for genetic counselor, IT specialist, and clinic personnel. CGC attendance was tracked via study database. Patient satisfaction was assessed 1 week post-CGC via telephone survey using validated scales. Total costs were $106 per telegenetics patient and $244 per in-person patient. Patient satisfaction did not differ by group on either satisfaction scale. In-person patients were significantly more likely to attend CGC than telegenetics patients (89 vs. 79 %, p = 0.03), with bivariate analyses showing an association between lesser computer comfort and lower attendance rate (Chi-square = 5.49, p = 0.02). Our randomized trial of telegenetics vs. in-person counseling found that telegenetics cost less than in-person counseling, with high satisfaction among those who attended. This study provides support for future randomized trials comparing multiple service delivery models on longer-term psychosocial and behavioral outcomes.