Increasing informed uptake and non-uptake of screening: evidence from a systematic review.
Increasing informed uptake and non-uptake of screening: evidence from a systematic review.
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DOI：
10.1046/j.1369-6513.2001.00143.x
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发表时间：
2001-06-01
期刊：
影响因子：
--
通讯作者：
Lewis, R A
中科院分区：
文献类型：
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作者：
Jepson, R G;Forbes, C A;Lewis, R A
目的：为了报告有关知情的筛查tests. EQUTEGY摄取的数据：电子数据库，书目和专家被用来确定相关的出版和未出版的研究，直到2000年8月。纳入标准：随机对照试验，准随机对照试验和对照试验的干预措施，旨在增加知情的筛查摄取。所有参加者都符合个别方案的入学标准。研究报告的实际摄取，并满足三个四个标准用于定义知情uptake.DATA提取和合成：相关的研究进行了识别，数据提取和其有效性评估由两个独立的审查。结果数据包括筛查摄取、知识、知情决策和对筛查的态度。采用随机效应模型计算个体相对危险度和95%可信区间。主要结果：6项对照试验（5项随机对照试验和1项准随机对照试验）集中在产前和前列腺特异性抗原筛查。所有报告的筛查风险/获益和评估的知识。其中两个还评估了决策。两人报告了所有随机分组的风险/益处，并评估了不同的信息呈现方式。也没有发现，干预措施，如视频，决策树的信息传单，或触摸屏电脑传达任何额外的好处超过精心准备的传单.CONCLUSIONS：有一些证据表明，改变知情选择的干预措施，在筛选的格式不改变知识，满意度或有关筛选的决定。目前尚不清楚筛查中的知情选择是否会影响吸收。需要更多设计良好的随机对照试验，进一步的研究也应该针对发展一个有效的工具，衡量所有组成部分的知情选择的筛选。
OBJECTIVE: To report data relating to the informed uptake of screening tests.SEARCH STRATEGY: Electronic databases, bibliographies and experts were used to identify relevant published and unpublished studies up until August 2000.INCLUSION CRITERIA: RCTs, quasi-RCTs and controlled trials of interventions aimed at increasing the informed uptake of screening. All participants were eligible as defined by the entry criteria of individual programmes. Studies had to report actual uptake and meet three out of four criteria used to define informed uptake.DATA EXTRACTION AND SYNTHESIS: Relevant studies were identified, data extracted and their validity assessed by two reviewers independently. Outcome data included screening uptake, knowledge, informed decision-making and attitudes to screening. A random-effects model was used to calculate individual relative risks and 95% confidence intervals.MAIN RESULTS: Six controlled trials (five RCTs and one quasi-RCT), focusing on antenatal and prostate specific antigen screening, were included. All reported risks/benefits of screening and assessed knowledge. Two also assessed decision-making. Two reported risks/benefits to all randomized groups and evaluated different ways of presenting information. Neither found that interventions such as videos, information leaflets with decision trees, or touch screen computers conveyed any additional benefits over well-prepared leaflets.CONCLUSIONS: There is some evidence to suggest that changing the format of informed choice interventions in screening does not alter knowledge, satisfaction or decisions about screening. It is not clear whether informed choice in screening affects uptake. More well-designed RCTs are required and further research should also be directed towards the development of a valid instrument for measuring all components of informed choice in screening.