Communication for personalized decision making

在这个项目中，我们建议开发和测试一种支持临床决策的沟通策略。 关于个性化乳腺癌筛查范例的关键一步，即开始乳腺癌的年龄 放映。乳房X光检查的绝对益处根据乳房发育的风险而有所不同。 癌症，一种取决于多种因素的风险，尤其是年龄。患乳腺癌风险较低的女性 将从筛查中获得较小的绝对收益，但可能具有相同的假阳性风险 以及其他不良反应。根据特定筛选策略的风险-收益比的这种变化 个体特征是个性化筛选范例的基础。然而，几乎没有 关于如何最好地向考虑筛查的女性传达这一信息的证据。 拟议的项目包括两个阶段。在第一阶段，我们会进行一连串的实验研究，以 考察不同交际策略对理解的影响及其相互关系 筛选意图以及场景中的绝对收益和风险。基于以下方面的最新进展 传播学理论和我们的前期工作，我们将重点放在范例和 涉及信息来源的专门知识和动机的信息。在第二阶段，我们将测试一个决策 基于初级保健中交叉、群集化随机对照试验的第1阶段结果的援助 人口，考察其对知识、决策满意度和筛选的影响。关注相关性 筛查的绝对效益和筛查利用之间的关系。 小灵通

In this project, we propose to develop and test a communication strategy to support clinical decision making about a key step in a personalized breast cancer screening paradigm, the age of initiating breast cancer screening. The absolute benefit of mammography screening varies according to risk of developing breast cancer, a risk that depends upon multiple factors and particularly age. Women at lower risk of breast cancer will experience smaller absolute benefits from screening, but are likely to have the same risk of false positives and other adverse effects. This variation in the risk-benefit ratio of a particular screening strategy according to individual characteristics is fundamental to the personalized screening paradigm. However, there is little evidence about how best to communicate this information to women considering screening. The proposed project includes two phases. In Phase 1, we will conduct a series of experimental studies to examine the effect of alternative communication strategies on comprehension and the correlation between screening intentions and the absolute benefit and risk in the scenarios. Based on recent advances in communication theory and our preliminary work, we will focus on the potential impact of exemplars and of information addressing the expertise and motives of the information sources. In Phase 2, we will test a decision aid based upon the results of Phase 1 in an cross-over, clustered randomized controlled trial in a primary care population, examining its effects on knowledge, decision satisfaction and screening.focusing on the correlation between the absolute benefit of screening and screening utilization. PHS