Differences in treatment choices between prostate cancer patients using a decision aid and patients receiving care as usual: results from a randomized controlled trial.
Differences in treatment choices between prostate cancer patients using a decision aid and patients receiving care as usual: results from a randomized controlled trial.
复制标题
DOI：
10.1007/s00345-021-03782-7
复制
发表时间：
2021-12
影响因子：
3.4
通讯作者：
Kil PJM
中科院分区：
文献类型：
--
作者：
Lamers RED;Cuypers M;de Vries M;van de Poll-Franse LV;Bosch JLHR;Kil PJM
确定决策辅助 (DA) 的使用是否影响低风险和中风险前列腺癌 (PC) 患者的治疗决策。 在一项整群随机对照试验中，患者被随机分为使用 DA（DA 组）或不使用 DA（对照组）。 2014年至2016年间，荷兰18家医院招募了新诊断的低或中危PC患者。 DA 用户可以访问基于网络的 DA，该 DA 提供一般 PC 信息、PC 治疗信息和价值观澄清练习，以了解个人对治疗方案的偏好。对照组患者照常接受护理。使用多级逻辑回归分析治疗选择的差异。使用皮尔逊卡方检验比较各组之间合格治疗方案的差异。 382 名患者给予知情同意（DA 组 N = 273 例，对照组 N = 109 例）。问卷答复率为88%（N = 336）。 38% 的患者选择主动监测 (AS)，98% 的患者选择根治性前列腺切除术 (RP)，88% 的患者选择外照射放射治疗 (EBRT)，79% 的患者选择近距离放射治疗 (BT)。 DA 用户接受 AS 的频率明显高于对照组。患者（29 vs 16%，p = 0.01），而后者更常选择 BT（29 vs 18%，p< 0.01）。 RP 和 EBRT 组之间没有发现差异。与对照组相比，不符合 AS 资格的 DA 用户接受手术的频率更高（53% vs 35%，p = 0.01）。患者和疾病特征在各组之间均匀分布。使用 DA 的 PC 患者比不使用 DA 的患者更常选择 AS 治疗方案。 在线版本包含可在 10.1007/s00345-021-03782-7 获取的补充材料。
To determine whether or not decision aid (DA) use influences treatment decisions in patients with low and intermediate risk prostate cancer (PC). In a cluster randomized controlled trial, patients were randomized to either DA use (DA group) or no DA use (control group). Between 2014 and 2016, newly diagnosed patients with low or intermediate risk PC were recruited in 18 hospitals in the Netherlands. DA users had access to a web-based DA that provided general PC information, PC-treatment information, and values clarification exercises to elicit personal preferences towards the treatment options. Control group patients received care as usual. Differences in treatment choice were analysed using multilevel logistic regressions. Differences in eligible treatment options between groups were compared using Pearson Chi-square tests. Informed consent was given by 382 patients (DA group N = 273, control group N = 109). Questionnaire response rate was 88% (N = 336). Active surveillance (AS) was an option for 38%, radical prostatectomy (RP) for 98%, external beam radiotherapy (EBRT) for 88%, and brachytherapy (BT) for 79% of patients. DA users received AS significantly more often than control group. Patients (29 vs 16%, p = 0.01), whereas the latter more often chose BT (29 vs 18%, p < 0.01). No differences were found between groups regarding RP and EBRT. DA users who were not eligible for AS, received surgery more often compared to the control group (53 vs 35%, p = 0.01). Patient and disease characteristics were evenly distributed between groups. DA-using PC patients chose the AS treatment option more often than non-DA-using patients did. The online version contains supplementary material available at 10.1007/s00345-021-03782-7.
登录
查看更多内容
影响因子：
5.7
作者：
Ash, D;Flynn, A;Blank, L
通讯作者：
Blank, L
影响因子：
2.5
作者：
Cuypers, Maarten;Lamers, Romy E. D.;de Vries, Marieke
通讯作者：
de Vries, Marieke
影响因子：
3.5
作者：
Lamers, Romy E. D.;Cuypers, Maarten;Kil, Paul J. M.
通讯作者：
Kil, Paul J. M.
影响因子：
7.4
作者：
Diefenbach, Michael A.;Mohamed, Nihal E.;Hall, Simon J.
通讯作者：
Hall, Simon J.
影响因子：
4.5
作者：
van Tol-Geerdink, Julia J.;Leer, Jan Willem;Stalmeier, Peep F.
通讯作者：
Stalmeier, Peep F.