Individualizing Decision Quality for Patients with Breast Cancer: A RCT of a Com

乳腺癌患者的个体化决策质量：一项随机对照试验

• 批准号: 8374173
• 负责人: SARAH T HAWLEY
• 金额: $ 43.46万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8374173
• 关键词: Address; Adjuvant; Benefits and Risks; Biological Assay; Breast Cancer Treatment; Cancer Patient; Caring; Catchment Area; Collaborations; Communication; Complex; Continuity of Patient Care; Data; Decision Making; Disease; Ensure; Face; Funding; Future; Genes; Genetic screening method; Goals; Indium; Instruction; Knowledge; Magnetic Resonance Imaging; Malignant Neoplasms; Methods; Newly Diagnosed; Outcome; Outcomes Research; Patient Care; Patient Preferences; Patients; Process; Randomized; Randomized Controlled Trials; Readiness; Reporting; Role; Series; Staging; Surgeon; Systemic Therapy; Testing; Translating; Work; base; cancer care; design; improved; innovation; malignant breast neoplasm; meetings; preference; satisfaction; tool; web site

Patients newly diagnosed with breast cancer face a series of complex decisions regarding locoregional and systemic treatment. Currently many of these decisions do not meet the definition of a high quality decision, defined as one that is both informed (i.e., based on an accurate understanding of the treatment risks and benefits) and preference-concordant (i.e., consistent with the patients' underlying preferences). Moreover, the introduction of evaluative tests has made these decisions more complicated for many patients. There is a need to improve the quality of locoregional and systemic treatment decisions for breast cancer patients, and to help patients understand the role of evaluative tests in this decision process. Ensuring patients can deliberate effectively about these decisions, assert their views and communicate with their clinicians is likely to improve their overall decision preparedness and satisfaction. Project 3 will focus on the third pillar of individualized care by evaluating the impact of an innovative decision tool on locoregional and systemic therapy decision making for newly diagnosed breast cancer patients. The innovative online decision tool has been developed and tested over the past two years by the CanSORT team (R21 CA129859). Pilot data suggests that this tool has a positive impact on patient knowledge and decision outcomes. The goal of project 3 is to evaluate the impact of this tool, after it is enhanced in collaboration with our Communication and Dissemination Core, on the quality of decision making for locoregional and systemic breast cancer treatment decision making. We will conduct a randomized controlled trial (RCT) of 444 newly diagnosed patients with invasive early stage breast cancer, seen by 28-30 surgeons in two SEER catchment areas. Patients will be randomized to view our comprehensive decision tool or a "state of the art" existing website. The primary outcomes will be the rate of high quality decisions about locoregional and systemic therapy for patients viewing the CanSORT tool vs. the existing website. Additional outcomes will include patient knowledge about evaluative tests and the extent of decision deliberation. The results of this RCT will be highly relevant to future breast cancer patients making these decisions and to their clinicians,

新诊断出乳腺癌的患者面临着一系列关于局部区域和癌症的复杂决定。 系统治疗。目前，其中许多决策不符合高质量决策的定义， 定义为既了解情况（即基于对治疗风险的准确理解和 利益）和偏好一致（即与患者的基本偏好一致）。而且， 评估测试的引入使许多患者的这些决定变得更加复杂。有一个 需要提高乳腺癌患者局部和全身治疗决策的质量，以及 帮助患者了解评估测试在此决策过程中的作用。确保患者能够 可能会有效地审议这些决定，坚持自己的观点并与临床医生沟通 提高他们的整体决策准备度和满意度。项目3将重点关注第三个支柱 通过评估创新决策工具对局部和系统的影响来提供个性化护理 新诊断的乳腺癌患者的治疗决策。创新的在线决策工具具有 由 CanSORT 团队 (R21 CA129859) 在过去两年中开发和测试。试点数据 表明该工具对患者知识和决策结果具有积极影响。目标是 项目 3 是评估该工具在与我们的沟通合作得到增强后的影响 和传播核心，关于局部区域和全身乳腺癌的决策质量 治疗决策。我们将对 444 名新诊断的患者进行随机对照试验 (RCT) 患有浸润性早期乳腺癌的患者，由两个 SEER 服务区域的 28-30 名外科医生进行诊治。 患者将被随机分配以查看我们的综合决策工具或“最先进的”现有网站。 主要结果将是关于局部和全身治疗的高质量决策的比率 患者查看 CanSORT 工具与现有网站。其他结果将包括患者 有关评估测试和决策审议程度的知识。本次 RCT 的结果将是 与未来做出这些决定的乳腺癌患者及其临床医生高度相关，