A comparative evaluation of risk communication formats in cancer prevention

癌症预防中风险沟通形式的比较评估

• 批准号: 7530014
• 负责人: James G Dolan
• 金额: $ 17.34万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7530014
• 关键词: Address; Adopted; Adverse effects; Affect; Age; Age-Years; Benefits and Risks; Biomedical Research; British; Caring; Characteristics; Clinical; Clinical Research; Clinical Trials; Communication; Comprehension; Cultural Backgrounds; Data; Data Display; Decision Making; Disadvantaged; Disease; Education; Educational Status; Effectiveness; Ensure; Evaluation; Event; Fibrinogen; Frequencies; Future; Gender; Genomics; Goals; Health; Health Personnel; Healthcare; Individual; Informed Consent; Intervention; Journals; Knowledge; Measures; Medical; Metabolic; Methods; Modeling; Monitor; Nature; New York; Outcome; Outcome Measure; Outpatients; Patients; Performance; Population; Preventive; Probability; Proteomics; Public Health; Purpose; Randomized; Range; Recommendation; Relative (related person); Research; Research Design; Research Personnel; Risk; Risk Estimate; Safety; Sample Size; Sampling; Science; Screening procedure; Socioeconomic Status; Test Result; Translations; Validity and Reliability; Visual; Work; base; cancer prevention; comparative; compare effectiveness; demographics; design; disorder risk; follow-up; hazard; health care quality; improved; information gathering; literacy; programs; racial and ethnic; research to practice; response

DESCRIPTION (provided by applicant): Effective communication about possible risks and benefits of medical interventions to patients has been an integral part of medical care since the doctrine of informed consent was adopted. In recent years, it has become increasingly more important due to changes in the accepted model of the doctor-patient relationship that promote more active involvement of patients in decisions about their care, the rise of evidence-based medical practice, and the increasing emphasis placed on preventive measures that are intended to reduce future health risks. Effective communication about the possible outcomes of medical interventions is also an essential component of methods for improving the translation of biomedical research findings into practice. Despite its importance, there are large gaps in our knowledge of how to effectively convey information about uncertain future events to patients and practitioners. The specific aims of this study are: 1) To provide initial estimates differences among currently recommended numeric and graphic formats in their ability to convey information to patients about possible outcomes that vary across a representative range of clinically important likelihoods and consequences; 2) To provide initial estimates of interactions between the effectiveness of the risk communication formats and patient characteristics including: numeracy, literacy, educational level, socio- economic status, age, and racial/ethnic background; and 3) To develop an analytic framework and to gather data about key parameters for use in planning and conducting a follow-up R01-level study that will thoroughly address these issues. The patient population will consist of demographically-stratified sample of 360 patients at least 18 years of age who are patients at three outpatient practices in Rochester New York. An incomplete factorial design with two five-level within-subject factors will be used. One factor will be five currently recommended risk communication formats: vertical bar charts, grouped icon displays, risk scales, frequency diagrams, and numeric frequency information. The other factor will be five outcomes of a disease screening program: risk of disease, risk of dying from disease, risk of a serious screening side effect, risk of dying from a screening side effect, and risk of a false positive screening test result. Each subject will be randomly assigned to respond to risk information in five of the possible 25 combinations such that they are presented with each risk outcome and each risk format in some combination. To facilitate the design of a future comprehensive R01-level study, data from this study will be used to gain initial estimates of risk format and subject variables on the differences among the five risk presentation formats on the following outcomes: a) comprehension, b) usefulness for decision making, c) hazard-response consistency, d) uniformity, e) patient evaluation, and f) direction of communication errors. We will also determine if there are associations between these outcomes and either the nature of the risk or individual patient characteristics including demographics, education, literacy, and numeracy. PUBLIC HEALTH RELEVANCE: Effective communication about possible risks and benefits of medical interventions is essential for ensuring the delivery of consistently high quality health care. Despite its importance, there are large gaps in our knowledge of how to effectively convey information about uncertain future outcomes of health care decisions to patients and practitioners. This project will begin to address these gaps by: a) comparing how well five currently recommended risk communication formats convey risk information to patients across a range of clinically important probabilities and outcomes, and b) determining whether patient characteristics such as demographics, numeracy, and literacy affect the effectiveness of health risk communications.

描述（由申请人提供）：自从采用知情同意原则以来，关于医疗干预措施可能给患者带来的风险和益处的有效沟通已成为医疗护理不可或缺的一部分。近年来，由于公认的医患关系模式的变化促进患者更积极地参与其护理决策、循证医疗实践的兴起以及越来越重视旨在减少未来健康风险的预防措施，这一点变得越来越重要。关于医疗干预可能结果的有效沟通也是改善生物医学研究成果转化为实践的方法的重要组成部分。尽管它很重要，但我们在如何向患者和从业者有效传达有关不确定的未来事件的信息方面的知识还存在很大差距。本研究的具体目的是： 1) 提供目前推荐的数字和图形格式之间的初步估计差异，因为它们向患者传达有关可能结果的信息的能力，这些信息在临床上重要的可能性和后果的代表性范围内有所不同； 2) 提供风险沟通形式有效性与患者特征之间相互作用的初步估计，包括：算术、识字、教育水平、社会经济地位、年龄和种族/民族背景； 3) 开发一个分析框架并收集有关关键参数的数据，用于规划和开展后续 R01 级研究，以彻底解决这些问题。患者群体将包括 360 名年龄至少 18 岁的患者的人口统计分层样本，他们是纽约州罗彻斯特三个门诊诊所的患者。将使用具有两个五水平受试者内因子的不完全因子设计。其中一个因素是目前推荐的五种风险沟通格式：垂直条形图、分组图标显示、风险量表、频率图和数字频率信息。另一个因素是疾病筛查计划的五个结果：疾病风险、死于疾病的风险、严重筛查副作用的风险、死于筛查副作用的风险以及假阳性筛查测试结果的风险。每个受试者将被随机分配以对 25 种可能的组合中的 5 种风险信息做出反应，以便向他们呈现某种组合中的每种风险结果和每种风险格式。为了促进未来综合 R01 级研究的设计，本研究的数据将用于获得风险格式和主题变量的初步估计，以了解五种风险呈现格式在以下结果方面的差异：a) 理解，b) 决策的有用性，c) 危险响应一致性，d) 一致性，e) 患者评估，f) 沟通错误的方向。我们还将确定这些结果与风险性质或个体患者特征（包括人口统计、教育、识字和算术）之间是否存在关联。公共卫生相关性：关于医疗干预措施可能存在的风险和益处的有效沟通对于确保提供始终如一的高质量医疗保健至关重要。尽管它很重要，但我们在如何有效地向患者和从业者传达有关医疗保健决策的不确定的未来结果的信息方面还存在很大差距。该项目将通过以下方式开始解决这些差距：a）比较目前推荐的五种风险沟通格式在一系列临床重要概率和结果中向患者传达风险信息的效果；b）确定患​​者特征（例如人口统计、算术和识字能力）是否影响健康风险沟通的有效性。