What is the impact of genetic counselling in women at increased risk of developing hereditary breast cancer? A meta-analytic review
What is the impact of genetic counselling in women at increased risk of developing hereditary breast cancer? A meta-analytic review
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DOI：
10.1016/s0277-9536(01)00133-2
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发表时间：
2002-05-01
影响因子：
5.4
通讯作者：
Halliday, JL
中科院分区：
文献类型：
--
作者：
Meiser, B;Halliday, JL
荟萃分析方法用于确定遗传咨询对有乳腺癌家族史的妇女的影响。已发表的前瞻性研究和随机对照试验纳入本综述，评估的心理结果为广泛性心理困扰、广泛性焦虑性抑郁和乳腺癌焦虑。调查的其他结果包括乳腺癌发病风险感知的准确性、乳腺癌遗传学知识和乳腺癌筛查的接受程度。在数据充足的情况下，进行了荟萃分析以估计效应大小。总共有122项研究，其中大多数测量了几个结果，至少符合一个纳入标准。有足够多的研究可用于评估对三个结果的影响程度：广泛性心理困扰、广泛性焦虑和患乳腺癌风险感知的准确性。定量综合显示，遗传咨询导致广泛性焦虑显著下降，平均加权效应值r = -0.17 （p < 0.01）。相比之下，心理困扰的减少仅表现出统计学意义的趋势，r = - 0.074 （p = 0.052）。遗传咨询对感知风险准确性的影响与效应值r = 0.56相关（p < 0.01）。因此，在本荟萃分析中，我们证明了遗传咨询在满足其两个目标方面的功效：降低女性的焦虑水平和提高其感知风险的准确性。这篇综述强调，到目前为止，大多数研究都集中在普遍的痛苦和焦虑以及感知风险的准确性上，而排除了其他可能同样重要的类型的结果。如果在评估中包括额外的情感、认知和行为结果，未来的研究可能会导致更全面的评估。(C) 2002 Elsevier Science Ltd.版权所有。
Meta-analytic methods were used to determine the impact of genetic counselling on women with a family history of breast cancer. Published studies with prospective designs and randomized controlled trials were included in the review, and the psychological outcomes assessed were generalized psychological distress, generalized anxiety depression, and breast cancer anxiety. Other outcomes investigated were the accuracy of perceived risk of developing breast cancer, breast cancer genetics knowledge and breast cancer screening uptake, A meta-analysis was performed to estimate effect size, where sufficient data were available. A total of 122 studies, most of which measured several outcomes, met at least one of the inclusion criteria. A sufficiently large number of studies were available to assess the magnitude of effects on three outcomes: generalized psychological distress, generalized anxiety and accuracy of perceived risk of developing breast cancer. The quantitative synthesis showed that genetic counselling leads to statistically significant decreases in generalized anxiety, with an average weighted effect sizes of r = -0.17 (p < 0.01). In contrast, the reduction in psychological distress exhibited a trend towards statistical significance only, with r = - 0.074 (p = 0.052). The impact of genetic counselling on the accuracy of perceived risk was associated with an effect size of r = 0.56 (p < 0.01). Thus in this meta-analysis, we demonstrated the efficacy of genetic counselling in meeting two of its objectives: reducing women's anxiety levels and improving the accuracy of their perceived risk. This review highlighted that most research so far focused on generalized distress and anxiety and accuracy of perceived risk, to the exclusion of other, perhaps equally important, types of outcomes. Future studies are likely to lead to more comprehensive assessments if additional emotional, cognitive and behavioural outcomes are included in the assessment. (C) 2002 Elsevier Science Ltd. All rights reserved.