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: 7257357
• 负责人: ISAAC M LIPKUS
• 金额: $ 16.66万
• 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 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7257357
• 关键词: Effects; Communicating; RPFNA; Results; Decisions

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高风险女性她们的乳腺癌（BC）风险，以帮助她们做出关于他莫昔芬（Tam）用于BC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，Rheumia）来对高风险患者进行风险分层并更精确地定义个体风险的方法是非常有前途的。为此，随机乳晕细针穿刺术（RPFNA）作为预测个体BC风险的研究工具显示出很大的希望。在作出知情决定的过程中，妇女必须了解《国家艾滋病毒/艾滋病区域方案》的结果意味着什么，以及如何根据其他风险因素将其应用于重新评估对艾滋病毒/艾滋病的看法，以及随后关于使用艾滋病毒/艾滋病评估工具的决定。影响上述过程的两个关键因素是患者的健康素养和算术水平。基于这一基本原理，拟议的研究将是第一个解决：1）患者如何真正理解和获得情感（即，情感）的意义，从RPFNA的结果; 2）以及这些理解如何影响的看法BC的风险和担心，以及随后的决策过程中涉及谭;以及3）计算能力和健康素养如何影响对BC风险的理解，并因此影响对BC风险的感知，以及涉及Tam的决策过程。为了实现这些目标，约120名参加杜克大学医学中心预防诊所的妇女，她们选择接受RPFNA，五年BC风险> 1.66%，将完成一项基线调查，评估：（1）对BC风险和担忧的看法，（2）对Tam的风险和益处的认识和看法，以及对其使用的兴趣，以及计算能力和健康素养。然后，妇女将接受RPFNA，并返回第二次诊所访问，以讨论结果。在咨询之后，我们将评估对结果的理解，并重新评估对BC风险和担忧、Tam的风险和益处以及使用决定的看法。研究结果有助于了解RPFNA和生物标志物如何更有效地整合到临床实践中，以影响对BC风险的认识和对BC预防策略的决策。这将是第一项研究，探讨在实际的临床实践中，乳腺癌风险认知，随机乳晕细针穿刺（RPFNA）结果和他莫昔芬之间的相互关系如何影响乳腺癌预防的决定;这项研究是在最前沿的学习可能的长处和短处，使用RPFNA作为一个模型，沟通生物标志物在临床实践中，可以推广到提供生物标记信息的其它方法的使用。研究结果可以有助于未来的干预措施，以提高有效的沟通和乳腺癌风险的理解，使用生物标志物和决策，涉及临床管理的护理妇女在较高的乳腺癌风险。