Effects of Communicating RPFNA Results on Decisions about Tamoxifen Use

交流 RPFNA 结果对他莫昔芬使用决策的影响

• 批准号: 7409976
• 负责人: ISAAC M LIPKUS
• 金额: $ 16.18万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-23 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7409976
• 关键词: Academic Medical Centers; Address; Affect; Affective; Atypia; Baseline Surveys; Benefits and Risks; Biological Markers; Breast Cancer Prevention; Caring; Chemoprevention; Clinic; Clinic Visits; Clinical; Clinical Management; Communication; Consultations; Decision Making; Emotional; Fine needle aspiration biopsy; Future; Goals; Health Status; High Risk Woman; Individual; Intervention; Knowledge; Learning; Light; Methods; Modeling; Patients; Perception; Prevention; Prevention strategy; Process; Research; Risk; Risk Factors; Tamoxifen; Techniques; Woman; base; cancer risk; health literacy; improved; interest; malignant breast neoplasm; tool

DESCRIPTION (provided by applicant): How do we best inform higher risk women of their breast cancer (BC) risk to assist them in making informed decisions about tamoxifen (Tam) for BC chemoprevention? To address this question, methods that use biomarkers, such as atypia, to risk-stratify high- risk patients and more precisely define individual risk is very promising. To this end, Random Periareolar Fine Needle Aspiration (RPFNA) shows much promise as a research tool predicting individual BC risk. For processes of informed decisions, women must have an understanding of what the RPFNA result means and how it applies to the reevaluation of perceptions of BC in light of other risk factors, and subsequent decisions about using Tam. Two factors that may be critical to affecting the above processes are patients' levels of health literacy and numeracy. Based on this rationale, the proposed study will be the first to address: 1) how patients factually understand and derive affective (i.e, emotional) meaning from the RPFNA result; 2) and how such understandings affect perceptions of BC risks and worry, and subsequent decision-making processes involving Tam; and 3) how numeracy and health literacy affect understanding, and as a result, perceptions of BC risk, and decision- making processes involving Tam. To address these goals, about 120 women attending the Prevention Clinic at Duke University Medical Center who elect to have RPFNA and have a five-year BC risk of > 1.66% will complete a baseline survey that assesses: (1) perceptions of BC risk and worry, (2) knowledge of and perceptions of Tam's risks and benefits and interest in its use as well as numeracy and health literacy. Women will then undergo RPFNA and return for a second clinic visit to discuss the result. Following the consultation, we will assess understanding of the result and reassess perceptions of BC risk and worry, Tam's risk and benefits and decision to use. Study results are relevant for understanding how RPFNA and biomarkers more generally can be integrated into clinical practice effectively to affect perceptions of BC risk and decision making about BC prevention strategies. This will be the first study to explore in actual clinical practice how the inter- relationships between breast cancer risk perceptions, Random Periareolar Fine Needle Aspiration (RPFNA) results, and Tamoxifen are understood to affect decisions about breast cancer prevention; this study is at the very forefront of learning about the possible strengths and weaknesses of using RPFNA as a model of communicating biomarkers in clinical practice that may generalize to the use of other methods of providing biomarker information. Findings can contribute to future interventions to improve the effective communication and understanding of breast cancer risk using biomarkers and decisions involving the clinical management of care among women at higher breast cancer risk.

描述（由申请人提供）：我们如何最好地告知妇女乳腺癌（BC）风险的较高风险，以帮助她们做出有关他莫昔芬（TAM）进行卑诗省化学预防的明智决定？为了解决这个问题，使用生物标志物（例如非洲专制）的方法将高风险患者施加风险分离，并且更精确地定义个人风险是非常有希望的。为此，作为一种研究工具，随机的周围细针吸入（RPFNA）表现出很大的希望，这是一种研究工具，可预测单个BC风险。对于明智的决策过程，妇女必须了解RPFNA结果的含义，以及如何适用于其他风险因素的重新评估BC的看法，以及随后使用TAM的决定。影响上述过程至关重要的两个因素是患者的健康素养和算术水平。基于此基本原理，拟议的研究将是第一个解决的研究：1）患者如何从RPFNA结果中理解和得出情感（即情感）含义； 2）以及这种理解如何影响卑诗省风险和忧虑的看法，以及随后涉及TAM的决策过程； 3）算术和健康素养如何影响理解，结果是对卑诗省风险的看法以及涉及TAM的决策过程。 To address these goals, about 120 women attending the Prevention Clinic at Duke University Medical Center who elect to have RPFNA and have a five-year BC risk of > 1.66% will complete a baseline survey that assesses: (1) perceptions of BC risk and worry, (2) knowledge of and perceptions of Tam's risks and benefits and interest in its use as well as numeracy and health literacy.然后，妇女将接受RPFNA并返回第二次诊所就诊，讨论结果。咨询后，我们将评估对卑诗省风险和忧虑，TAM的风险，福利以及使用的决定的理解以及重新评估的看法。研究结果与理解RPFNA和生物标志物如何有效地整合到临床实践中有关，以影响对卑诗省风险和对卑诗省预防策略的决策的看法。这将是在实际临床实践中探索的第一项研究，如何理解乳腺癌风险感知感知，随机的细针吸入（RPFNA）结果和他莫昔芬如何影响预防乳腺癌的决策；这项研究在学习使用RPFNA作为在临床实践中传达生物标志物的模型的可能优势和劣势的最前沿，该模型可能会推广到使用其他提供生物标志物信息的方法。调查结果可能有助于未来的干预措施，以使用生物标志物和涉及较高乳腺癌风险的妇女的临床护理管理的决定来改善对乳腺癌风险的有效沟通和理解。