BREAST CANCER GENE EDUCATION--COMPUTER VS PRACTITIONER

描述：（申请人摘要）拟定研究的目的 是确定基于计算机的教育是否与基于计算机的教育一样有效 以教师为基础的教育， 检测乳腺癌让病人在知情的情况下选择 乳腺癌的遗传易感性测试，他们需要信息 关于测试结果的意义，筛查的风险和益处， 基因评估的替代方法，以及阳性 测试结果.这对于遗传易感性尤其重要 乳腺癌，因为一些提出的“治疗”阳性测试， 结果（如预防性双侧乳房切除术）是侵入性的， 影响深远，而且未经证实。尽管需要事先提供信息， 筛查，一对一的教育是昂贵的，初级保健从业人员 不太可能有时间或专业知识来咨询 乳腺癌基因和遗传咨询师是稀缺的。 从业人员可使用成本低、效果好、可靠、可接受的 提供乳腺癌基因筛查信息的方法 给病人。在其他情况下，计算机已经成功地用于 传播医学信息。然而，目前尚不清楚， 计算机遗传教育方法可以有效地帮助患者 在乳腺癌基因筛查方面做出明智的选择。 主要的研究假设是，在测试中， 即时回忆有关乳房基因检查资料 接受电脑教育的病人患癌症的几率 以教师为基础的教育。次要假设是， 知识将影响接受测试的意图， 教育费用低于以教师为基础的教育。我们将测试 这些假设通过随机对照临床试验使用150 在两个研究地点的家族性乳腺癌高风险妇女。 合格受试者将随机接受以下治疗之一： 通过计算机或遗传咨询师进行教育。后立即 在教育干预中，受试者将被给予多项选择， 理解力测试。将测量此测试的分数，并分组 将进行比较。打算接受乳腺癌检测 在教育前后进行易感基因检测 干预，并将结果进行比较，以评估的影响， 对接受基因筛查的意向的了解。计算机费用- 基础教育将与以教师为基础的教育进行比较。

DESCRIPTION: (Applicant's Abstract) The objective of the proposed study is to determine whether computer-based education is as effective as practitioner-based education for increasing understanding of genetic testing for breast cancer. For patients to make informed choices about genetic susceptibility testing for breast cancer, they need information about the meaning of test results, risks and benefits of screening, alternatives to genetic evaluation, and options for those with positive test results. This is particularly important with genetic susceptibility to breast cancer, since some proposed "treatments" for positive test results (such as prophylactic bilateral mastectomy) are invasive, of profound impact, and unproven. Despite the need for information prior to screening, one-on-one education is costly, primary care practitioners are unlikely to have the time or specialized knowledge to counsel about the breast cancer gene, and genetic counselors are scarce. Practitioners could use a low cost, effective, reliable and acceptable method to provide information about genetic screening for breast cancer to patients. In other contexts, computers have been used successfully to disseminate medical information. It is not known, however, whether a computer approach to genetic education can effectively assist patients in making informed choices about genetic screening for breast cancer. The primary study hypothesis is that comprehension scores on a test of immediate recall of information about genetic screening for breast cancer will be as high for patients informed by computer-based education as by practitioner-based education. The secondary hypotheses are that knowledge will affect intent to receive testing and that computer-based education is less costly than practitioner-based education. We will test these hypotheses by a randomized controlled clinical trial using 150 women at high risk for familial breast cancer at two study sites. Consenting eligible subjects will be randomized to receive either education by computer or by genetic counselor. Immediately following the educational intervention, subjects will be given a multiple choice test of comprehension. Scores on this test will be measured, and group means will be compared. Intent to receive testing for the breast cancer susceptibility gene will be measured before and after the education intervention, and results will be compared to assess the effect of knowledge on intention to undergo genetic screening. Costs of computer- based education will be compared to practitioner-based education.