Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions.
Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions.
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对接受高级宫颈癌前病变治疗的女性的监测策略的偏好。
DOI：
10.1016/j.ygyno.2010.05.002
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发表时间：
2010
影响因子：
4.7
通讯作者：
Sawaya,GF
中科院分区：
文献类型：
--
作者：
Kuppermann,M;Melnikow,J;Slee,C;Tancredi,DJ;Kulasingam,S;Birch,S;Helms,LJ;Bayoumi,AM;Sawaya,GF
缺乏关于妇女如何看待高级别宫颈上皮内瘤变治疗后宫颈癌监测的替代方法的数据。我们测量和比较患者的偏好（效用）的情况下，不同的监测策略和结果，告知指导方针和成本效益分析的治疗后的监测options. METHODS英语或西班牙语的妇女谁收到了异常巴氏试验结果在过去的2 years被招募从普通妇科和阴道镜诊所和报纸和网上广告在2007年和2008年。参与包括一个面对面的采访，在此期间，公用事业的11个不同的监测方案及其相关的结果引起使用的时间权衡指标。一份社会人口学问卷也administered.ESTS65妇女同意参加，并成功地完成了偏好诱导练习。平均效用范围为0.989（仅接受巴氏试验，结果正常）至0.666（浸润性宫颈癌根治性子宫切除术或放疗和化疗）。接受巴氏和HPV检测并获得正常/阴性结果的平均效用（0.953）低于仅接受巴氏检测并获得正常结果的平均效用（0.989）。接受两种检测和接受正常巴氏涂片但HPV阳性结果的平均效用更低（0.909）。15.9%的受访者给予更高的效用分数的巴氏试验加HPV检测的情况下（正常/阴性结果）比“单独巴氏试验”的情况下（正常结果），而17.5%的巴氏试验单独的情况下，一个更高的效用scores. CONCLUSIONSPREERATIONS结束结果与正常结果，但涉及替代监测过程有很大的不同。所观察到的效用差异对临床指南和成本效益分析具有重要意义。
OBJECTIVESData are lacking on how women view alternative approaches to surveillance for cervical cancer after treatment of high-grade cervical intraepithelial neoplasia. We measured and compared patient preferences (utilities) for scenarios with varying surveillance strategies and outcomes to inform guidelines and cost-effectiveness analyses of post-treatment surveillance options.METHODSEnglish- or Spanish-speaking women who had received an abnormal Pap test result within the past 2years were recruited from general gynecology and colposcopy clinics and newspaper and online advertisements in 2007 and 2008. Participation consisted of one face-to-face interview, during which utilities for 11 different surveillance scenarios and their associated outcomes were elicited using the time tradeoff metric. A sociodemographic questionnaire also was administered.RESULTS65 women agreed to participate and successfully completed the preference elicitation exercises. Mean utilities ranged from 0.989 (undergoing only a Pap test, receiving normal results) to 0.666 (invasive cervical cancer treated with radical hysterectomy or radiation and chemotherapy). Undergoing both Pap and HPV tests and receiving normal/negative results had a lower mean utility (0.953) then undergoing only a Pap test and receiving normal results (0.989). Having both tests and receiving normal Pap but positive HPV results was assigned an even lower mean utility (0.909). 15.9% of the respondents gave higher utility scores to the Pap plus HPV testing scenario (with normal/negative results) than to the “Pap test alone” scenario (with normal results), while 17.5% gave the Pap test alone scenario a higher utility score.CONCLUSIONSPreferences for outcomes ending with normal results but involving alternative surveillance processes differ substantially. The observed differences in utilities have important implications for clinical guidelines and cost-effectiveness analyses.
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DOI：
--
发表时间：
1993
期刊：
影响因子：
--
作者：
R. Baker;J. Tilbury
通讯作者：
J. Tilbury
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DOI：
--
发表时间：
2002
期刊：
The Journal of family practice.
影响因子：
--
作者：
Melnikow,Joy;Kuppermann,Miriam;Birch,Stephen;Chan,BenjaminKS;Nuovo,Jim
通讯作者：
Nuovo,Jim
DOI：
10.1037//0278-6133.10.4.259
发表时间：
1991
期刊：
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
影响因子：
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作者：
Lerman,C;Trock,B;Rimer,BK;Jepson,C;Brody,D;Boyce,A
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Boyce,A
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影响因子：
2.2
作者：
R. Kaplan
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R. Kaplan
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DOI：
10.1002/hec.783
发表时间：
2003
期刊：
Health economics.
影响因子：
--
作者：
Birch,Stephen;Melnikow,Joy;Kuppermann,Miriam
通讯作者：
Kuppermann,Miriam