Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility - A randomized controlled trial
Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility - A randomized controlled trial
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DOI：
10.1001/jama.292.4.442
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发表时间：
2004-07-28
影响因子：
120.7
通讯作者：
Manger, DT
中科院分区：
文献类型：
--
作者：
Green, MJ;Peterson, SK;Manger, DT
背景随着初级保健和其他临床环境中遗传性癌症基因检测的可用性和需求的增加，需要传统遗传咨询的替代或辅助教育方法。目的比较计算机的有效性-基于决策援助与标准遗传咨询教育妇女BRCA 1和BRCA 2基因检测。设计随机对照试验，从2000年5月，2002年9月。设置和参与者在美国6个医疗中心提供癌症遗传咨询的门诊诊所招募了211名有乳腺癌个人或家族史的妇女。干预标准一对一遗传咨询（n = 105）或遗传咨询后通过计算机程序进行教育（n = 106）。主要结果测量参与者的知识，风险感知，基因检测意愿、决策冲突、决策满意度、焦虑、干预满意度。辅导员组的措施，在基线和咨询后进行管理。在基线、使用计算机后和咨询后进行计算机组测量。在1个月和6个月时评估试验决策。结果进行了分析，高与低风险携带BRCA 1或BRCA 2 mutation.Results两组有可比的人口统计学，以前的计算机经验，医学素养，乳腺癌和基因检测的基线知识，咨询和计算机使用的评价很高。两组知识得分均增加（P
Context As the availability of and demand for genetic testing for hereditary cancers increases in primary care and other clinical settings, alternative or adjunct educational methods to traditional genetic counseling will be needed.Objective To compare the effectiveness of a computer-based decision aid with standard genetic counseling for educating women about BRCA1 and BRCA2 genetic testing.Design Randomized controlled trial conducted from May 2000 to September 2002.Setting and Participants Outpatient clinics offering cancer genetic counseling at 6 US medical centers enrolled 211 women with personal or family histories of breast cancer.Interventions Standard one-on-one genetic counseling (n = 105) or education by a computer program followed by genetic counseling (n = 106).Main Outcome Measures Participants' knowledge, risk perception, intention to undergo genetic testing, decisional conflict, satisfaction with decision, anxiety, and satisfaction with the intervention. Counselor group measures were administered at baseline and after counseling. Computer group measures were administered at baseline, after computer use, and after counseling. Testing decisions were assessed at 1 and 6 months. Outcomes were analyzed by high vs low risk of carrying a BRCA1 or BRCA2 mutation.Results Both groups had comparable demographics, prior computer experience, medical literacy, and baseline knowledge of breast cancer and genetic testing, and both counseling and computer use were rated highly. Knowledge scores increased in both groups (P