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Evaluating a decision aid for breast cancer prevention: a pilot trial

评估乳腺癌预防决策辅助：试点试验

基本信息

批准号：
8036096
负责人：
G SCOTT GAZELLE
金额：
$ 18.67万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-03-01 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8036096
关键词：
Achievement Address Adverse effects Age Area Behavior Therapy Breast Cancer Prevention Caring Cause of Death Chemoprevention Clinic Clinical Clinical Research Clinical Trials Communication Communities Conflict (Psychology)Consultations Data Decision Aid Decision Making Development Disease Effectiveness Ensure Environment Equilibrium Evidence Based Medicine Frequencies General Hospitals Goals Health Incidence Intervention Knowledge Lead Malignant Neoplasms Massachusetts Measures Medical Methods Morbidity - disease rate Online Systems Operative Surgical Procedures Outcome Patient Participation Patient-Centered Care Patients Perception Physicians Positioning Attribute Prevention Preventive Intervention Primary Prevention Process Provider Raloxifene Randomized Controlled Trials Research Risk Science Tamoxifen Testing Time United States Visit Woman Women&apos s Health Work base cancer risk comparative effectiveness design effectiveness research evidence base experience improved malignant breast neoplasm mortality patient oriented pilot trial preference primary care setting prophylactic public health relevance satisfaction standard care systematic review tool treatment adherence

项目摘要

DESCRIPTION (provided by applicant): In the United States, breast cancer is the most common cancer among women and the leading cause of death in women between the ages of 45-60. The efficacy of prevention options such as chemoprevention and prophylactic surgery has been established. Yet breast cancer prevention remains underused, resulting in avoidable morbidity and mortality. The main barriers to effective use of breast cancer prevention are inaccurate perceptions of these interventions by patients and challenges to providers in identifying eligible patients. To address these barriers, our research will use a decision aid in the primary care setting to facilitate patient-centered and evidence-based breast cancer prevention. THE APPROACH: Building on our previous work, we will evaluate the clinical feasibility and efficacy of a decision aid for breast cancer prevention in the primary care setting. First, we will adapt our previously developed decision aid for use in the primary care setting. Second, we will conduct a randomized controlled trial to evaluate the effectiveness of two methods of delivery for the decision aid (use of the decision aid prior to the consultation, or during the consultation). THE INVESTIGATIVE TEAM AND ENVIRONMENT: The investigative team is highly interdisciplinary and brings together the necessary experience and expertise to accomplish the proposed research. Areas of expertise include: clinical research, clinical decision support methods, women's health, breast cancer prevention, and statistical analyses. The proposed team has developed and evaluated numerous decision support tools and methods making them uniquely suited and well-positioned to successfully complete the proposed research. THE POTENTIAL IMPACT: The goal of the proposed research is to further the science and application of informed decision making and patient-centered care in the context of breast cancer prevention. Our research will improve patient decisions about prevention by ensuring that their choices are aligned with current clinical knowledge and their own values. Targeting the primary care setting will enable the widespread identification of women who are likely to benefit from prevention interventions. By testing two methods of delivery for the decision aid, we aim to further the science of decision aid development and implementation. This work is ultimately expected to improve patient health outcomes and decrease the burden of breast cancer. PUBLIC HEALTH RELEVANCE: Significant advances in options for breast cancer prevention present an opportunity to reduce the incidence of this deadly disease. Yet breast cancer prevention remains underused, resulting in avoidable morbidity and mortality. Our research will use a decision aid in the primary care setting to facilitate the use of patient- centered and evidence-based breast cancer prevention.

描述（由申请人提供）：在美国，乳腺癌是女性中最常见的癌症，也是 45-60 岁女性死亡的主要原因。化学预防和预防性手术等预防方案的有效性已经确定。然而，乳腺癌预防措施仍未得到充分利用，导致了本可避免的发病率和死亡率。有效利用乳腺癌预防的主要障碍是患者对这些干预措施的不准确认知以及提供者在识别合格患者方面面临的挑战。为了解决这些障碍，我们的研究将在初级保健环境中使用决策辅助，以促进以患者为中心和基于证据的乳腺癌预防。方法：在我们之前的工作基础上，我们将评估初级保健机构中乳腺癌预防决策辅助的临床可行性和有效性。首先，我们将调整之前开发的决策辅助工具以用于初级保健环境。其次，我们将进行随机对照试验，以评估两种决策辅助交付方法（在咨询之前或咨询期间使用决策辅助）的有效性。研究团队和环境：研究团队是高度跨学科的，汇集了完成拟议研究所需的经验和专业知识。专业领域包括：临床研究、临床决策支持方法、妇女健康、乳腺癌预防和统计分析。拟议的团队开发并评估了许多决策支持工具和方法，使其非常适合并处于有利位置，可以成功完成拟议的研究。潜在影响：拟议研究的目标是在乳腺癌预防的背景下进一步推进知情决策和以患者为中心的护理的科学和应用。我们的研究将通过确保患者的选择符合当前的临床知识和他们自己的价值观来改善他们的预防决策。以初级保健机构为目标将能够广泛识别可能从预防干预措施中受益的妇女。通过测试决策援助的两种交付方法，我们的目标是进一步提高决策援助开发和实施的科学性。这项工作最终有望改善患者的健康状况并减轻乳腺癌的负担。公共卫生相关性：乳腺癌预防方案的重大进步为降低这种致命疾病的发病率提供了机会。然而，乳腺癌预防措施仍未得到充分利用，导致了本可避免的发病率和死亡率。我们的研究将在初级保健环境中使用决策辅助工具，以促进以患者为中心和基于证据的乳腺癌预防。