A comparative evaluation of risk communication formats in cancer prevention

癌症预防中风险沟通形式的比较评估

基本信息

批准号：
7643997
负责人：
James G Dolan
金额：
$ 14.5万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-07-01 至 2010-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7643997
关键词：
18 year old Address Adopted Adverse effects Affect Age Benefits and Risks Biomedical Research British Caring Characteristics Clinical Clinical Research Clinical Trials Communication Comprehension Cultural Backgrounds Data Data Display Decision Making Disadvantaged Disease Education Educational Status Effectiveness Ensure Evaluation Event Fibrinogen Frequencies Future Gender Genomics Goals Health Health Personnel Healthcare Individual Informed Consent Intervention Journals Knowledge Measures Medical Metabolic Methods Modeling Monitor Nature New York Outcome Outcome Measure Outpatients Patients Performance Preventive Probability Proteomics Randomized Recommendation Relative (related person)Research Research Design Research Personnel Risk Risk Estimate Safety Sample Size Sampling Science Screening procedure Socioeconomic Status Test Result Translational Research Translations Validity and Reliability Visual Work base cancer prevention comparative compare effectiveness data format demographics design disorder risk evidence base follow-up hazard health care quality improved information gathering literacy patient population programs public health relevance racial and ethnic research to practice response

项目摘要

DESCRIPTION (provided by applicant): Effective communication about possible risks and benefits of medical interventions to patients has been an integral part of medical care since the doctrine of informed consent was adopted. In recent years, it has become increasingly more important due to changes in the accepted model of the doctor-patient relationship that promote more active involvement of patients in decisions about their care, the rise of evidence-based medical practice, and the increasing emphasis placed on preventive measures that are intended to reduce future health risks. Effective communication about the possible outcomes of medical interventions is also an essential component of methods for improving the translation of biomedical research findings into practice. Despite its importance, there are large gaps in our knowledge of how to effectively convey information about uncertain future events to patients and practitioners. The specific aims of this study are: 1) To provide initial estimates differences among currently recommended numeric and graphic formats in their ability to convey information to patients about possible outcomes that vary across a representative range of clinically important likelihoods and consequences; 2) To provide initial estimates of interactions between the effectiveness of the risk communication formats and patient characteristics including: numeracy, literacy, educational level, socio- economic status, age, and racial/ethnic background; and 3) To develop an analytic framework and to gather data about key parameters for use in planning and conducting a follow-up R01-level study that will thoroughly address these issues. The patient population will consist of demographically-stratified sample of 360 patients at least 18 years of age who are patients at three outpatient practices in Rochester New York. An incomplete factorial design with two five-level within-subject factors will be used. One factor will be five currently recommended risk communication formats: vertical bar charts, grouped icon displays, risk scales, frequency diagrams, and numeric frequency information. The other factor will be five outcomes of a disease screening program: risk of disease, risk of dying from disease, risk of a serious screening side effect, risk of dying from a screening side effect, and risk of a false positive screening test result. Each subject will be randomly assigned to respond to risk information in five of the possible 25 combinations such that they are presented with each risk outcome and each risk format in some combination. To facilitate the design of a future comprehensive R01-level study, data from this study will be used to gain initial estimates of risk format and subject variables on the differences among the five risk presentation formats on the following outcomes: a) comprehension, b) usefulness for decision making, c) hazard-response consistency, d) uniformity, e) patient evaluation, and f) direction of communication errors. We will also determine if there are associations between these outcomes and either the nature of the risk or individual patient characteristics including demographics, education, literacy, and numeracy. PUBLIC HEALTH RELEVANCE: Effective communication about possible risks and benefits of medical interventions is essential for ensuring the delivery of consistently high quality health care. Despite its importance, there are large gaps in our knowledge of how to effectively convey information about uncertain future outcomes of health care decisions to patients and practitioners. This project will begin to address these gaps by: a) comparing how well five currently recommended risk communication formats convey risk information to patients across a range of clinically important probabilities and outcomes, and b) determining whether patient characteristics such as demographics, numeracy, and literacy affect the effectiveness of health risk communications.

描述（由申请人提供）：自知情同意书学说以来，就医疗干预措施的可能风险和益处的有效沟通一直是医疗服务的组成部分。近年来，由于公认的医生关系模型的变化变化越来越重要，该模型的变化促进了患者在决策，基于证据的医疗实践的崛起以及对预防措施的越来越重视旨在减少未来健康风险的预防措施的越来越重视。关于医疗干预措施可能结果的有效沟通也是改善生物医学研究结果转化为实践的方法的重要组成部分。尽管它很重要，但我们关于如何有效地将有关未来事件的信息传达给患者和从业者的知识存在很大的差距。这项研究的具体目的是：1）提供当前推荐的数字和图形格式之间的初始估计差异，以便向患者传达信息的可能结果在一系列代表性的临床上重要的可能性和后果的能力中； 2）提供对风险交流格式和患者特征的有效性之间相互作用的初步估计，包括：算术，识字，教育水平，社会经济地位，年龄和种族/种族/种族背景； 3）开发一个分析框架并收集有关关键参数的数据，以计划和进行后续R01级研究，该研究将彻底解决这些问题。该患者人群将包括360名患者的人口统计学样本，至少18岁，他们是纽约罗切斯特（Rochester）三种门诊治疗的患者。将使用具有两个五级主体内因子的不完整阶乘设计。一个因素将是当前推荐的风险通信格式的五个因素：垂直条形图，分组图标显示，风险量表，频率图和数字频率信息。另一个因素将是疾病筛查计划的五个结果：疾病的风险，死于疾病的风险，严重筛查副作用的风险，因筛查副作用而死的风险以及假阳性筛查测试结果的风险。每个受试者将被随机分配，以响应25种可能组合中的5个组合中的5个风险信息，以便将它们与每种风险结果和每种风险格式进行某种组合呈现。 To facilitate the design of a future comprehensive R01-level study, data from this study will be used to gain initial estimates of risk format and subject variables on the differences among the five risk presentation formats on the following outcomes: a) comprehension, b) usefulness for decision making, c) hazard-response consistency, d) uniformity, e) patient evaluation, and f) direction of communication errors.我们还将确定这些结果之间是否存在关联，以及风险的性质或个人患者特征的性质，包括人口统计学，教育，识字和算术。公共卫生相关性：有关医疗干预措施的可能风险和益处的有效沟通对于确保提供一贯的高质量医疗保健至关重要。尽管它很重要，但我们的知识却存在很大的差距，即如何有效地传达有关医疗保健决策未来结果的信息。该项目将开始解决这些差距：a）比较五种当前建议的风险通信格式如何向患者传达一系列临床重要概率和结果的风险信息，b）确定诸如人口统计学，算法和识字之类的患者特征是否会影响健康风险沟通的有效性。