What Is Most Important to Patients when Deciding about Colorectal Screening?
What Is Most Important to Patients when Deciding about Colorectal Screening?
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DOI：
10.1007/s11606-010-1318-9
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发表时间：
2010-07-01
影响因子：
5.7
通讯作者：
Fraenkel, Liana
中科院分区：
文献类型：
--
作者：
Imaeda, Avlin;Bender, Danielle;Fraenkel, Liana
结直肠癌 (CRC) 筛查可以通过具有不同特征的测试进行，并且是一个偏好敏感的决定。使用最大差异标度 (MDS) 工具评估患者体验，以得出有关 CRC 筛查测试特征的值，并确定患者在优先考虑测试特征的方式上是否存在差异，以及这种差异是否与测试偏好相关。MDS 调查可得出患者对粪便潜血测试、乙状结肠镜检查、结肠镜检查、CT 结肠成像和结肠胶囊内窥镜检查相关特征的值。92 名患者参加了退伍军人事务部医院和相关大学的初级保健诊所。患者报告该工具易于使用（95%）。完成后，62% 的人会选择结肠镜检查，23% 的人会选择结肠胶囊内窥镜检查，10% 的人会选择 CT 结肠造影。在评估的属性中，患者最看重敏感性、撕裂风险和需要进行第二次测试。对于选择结肠镜检查的患者而言，敏感性比选择其他检查的患者更重要（中位重要性 = 21.5 与 19.6，p < 0.01）。对并发症和镇静的担忧与年龄呈正相关（p < 0.001 和 p < 0.001），而对结肠准备和缺失工作的担忧与年龄呈负相关（p < 0.009 和 p < 0.03）。与健康状况良好或极好的患者相比，健康状况一般或较差的患者不太关心敏感性（中位重要性 = 19.3 与 21.4，p < 0.008）。这项试点研究表明，患者对结直肠癌筛查测试属性的优先顺序的看法各不相同；这种变化与测试偏好相关，并且该 MDS 工具使用起来可行，并且可以帮助患者构建他们的偏好。
Colorectal cancer (CRC) screening can be administered through tests with varied characteristics and is a preference-sensitive decision.To assess patient experiences with a Maximum Differences Scaling (MDS) tool for eliciting values about CRC screening test characteristics and determine whether patients vary in how they prioritize test characteristics and whether this variation relates to test preferences.MDS survey to elicit patients' values for characteristics related to fecal occult blood testing, sigmoidoscopy, colonoscopy, CT colonography and colon capsule endoscopy.92 patients enrolled in primary care clinics at a VA hospital and associated university.Patients reported that the tool was easy to use (95%). On completion 62% would choose colonoscopy, 23% colon capsule endoscopy and 10% CT colonography. Of the attributes evaluated, patients valued sensitivity, risk of tear and need for a second test most. Sensitivity was more important to those choosing colonoscopy than those choosing other tests (median importance = 21.5 versus 19.6, p < 0.01). Concern with complications and sedation was positively associated with age (p < 0.001 and p < 0.001), whereas concern with colon preparation and missing work was negatively associated with age (p < 0.009 and p < 0.03). Patients with fair or poor health status were less concerned with sensitivity than patients in good to excellent health (median importance = 19.3 versus 21.4, p < 0.008).This pilot study suggests that patients vary in how they prioritize colorectal cancer screening test attributes; this variation is associated with test preferences, and this MDS tool is feasible to use and may help patients construct their preferences.