Patient Preferences for Test Result Notification.
Patient Preferences for Test Result Notification.
复制标题
患者对测试结果通知的偏好。
DOI：
10.1007/s11606-015-3344-0
复制
发表时间：
2015
影响因子：
5.7
通讯作者：
Cram,Peter
中科院分区：
文献类型：
--
作者：
Shultz,SamuelK;Wu,Robert;Matelski,JohnJ;Lu,Xin;Cram,Peter
重要的是，越来越多的患者可以接触到他们的测试结果，但很少有人知道他们的偏好如何随着正在考虑的测试或测试结果而变化（正常或异常）。本研究的目的是检查测试结果通信的偏好。设计，设置，我们对成年人进行了调查，以探索他们对三种不同“情绪影响”的常见诊断测试的测试结果通知的偏好。（双能X射线吸收测定法[DXA]、生殖器疱疹和癌症活检），当测试结果1）正常和2）异常时。我们于2012年6月至8月在一所学术医疗中心的校园内进行了调查。对于每一种情况，受试者被要求对可能用于传达测试结果的七种方法进行排名（信件、不安全电子邮件、安全电子邮件、短信、电话、安全门户网站，办公室访问）主要结果测量主要测量是对特定测试结果通知方法进行好评的受访者百分比和将其列为不可接受的百分比。正常，受试者对DXA、疱疹和癌症活检的通知偏好大致相似，电话和信件对所有三种测试都是最有利的。相反，在所有三项测试中，45.0- 55.0%的受试者认为短信和不安全的电子邮件是不可接受的正常结果通知方法。当测试结果异常时，办公室访问变得更受欢迎。与DXA（28.2%）和疱疹（27.9%）相比，更高比例的受试者将办公室访视列为我们测试中最首选的通知方法，具有高“情感影响”（癌症活检）（38.4%）（P= 0.02）。对于大多数测试场景，年轻的受试者似乎排名电子通信方式（安全的电子邮件或门户网站）高于老年受试者，虽然这种差异没有达到统计学意义（P= 0.29）。提供者和医疗保健系统在决定如何向患者传达结果时应考虑这些因素。
ImportancePatients are increasingly being given access to their test results, but little is known about how preferences vary with the test under consideration or the results of the test (normal or abnormal).ObjectiveThis study was conducted to examine preferences for test result communication.Design, Setting, and ParticipantsWe surveyed adults to explore their preferences for test result notification for three common diagnostic tests of varying “emotional impact” (dual-energy x-ray absorptiometry [DXA], genital herpes, and cancer biopsy) when test results were 1) normal and 2) abnormal. We conducted our survey between June and August 2012 on the campus of an academic medical center. For each scenario, subjects were asked to rank seven methods that might be used to communicate test results (letter, unsecured email, secured email, text message, telephone call, secure Web portal, office visit) in order of acceptability.Main Outcome MeasuresThe main measures were the percentage of respondents who ranked a particular test result notification method favorably and the percentage who ranked it as unacceptable.ResultsWhen test results were normal, subjects’ notification preferences were generally similar for DXA, herpes and cancer biopsy, with telephone and letter ranked most favorably for all three tests. Conversely, text message and unsecured email were viewed as unacceptable notification methods for normal results by 45.0–55.0 % of subjects across all three tests. When test results were abnormal, office visits became more popular. A higher proportion of subjects ranked office visits as their most preferred notification method for our test with high “emotional impact” (cancer biopsy) (38.4 %) as compared to DXA (28.2 %) and herpes (27.9 %) (P= 0.02). For most test scenarios, younger subjects appeared to rank electronic communication modalities (secure email or Web portal) higher than older subjects, though this difference did not reach statistical significance (P= 0.29).ConclusionsPreferences for test result notification can differ substantially depending upon the test under consideration and results of the test. Providers and health care systems should consider these factors when deciding how to communicate results to patients.