Development of a Conjoint Analysis Instrument for Lung Cancer Screening Decisions

肺癌筛查决策联合分析仪器的开发

• 批准号: 7991230
• 负责人: Margaret M Byrne
• 金额: $ 21.96万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-15 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7991230
• 关键词: Address; Advocate; Affect; Agreement; Blood; Cancer Etiology; Cessation of life; Characteristics; Client satisfaction; Cognitive; Complex; Computer software; Decision Aid; Decision Making; Development; Diagnosis; Diagnostic Neoplasm Staging; Diagnostic radiologic examination; Dose; Ensure; Face; Future; Genetic; Genetic Markers; Goals; Health Personnel; Health Services Research; Imaging Techniques; Individual; Interview; Lead; Lung; Malignant neoplasm of lung; Methodology; Methods; National Cancer Institute; Nodule; Online Systems; Outcome; Patients; Persons; Phase; Process; Public Health; Recommendation; Research; Risk; Sampling; Screening procedure; Serum; Smoker; Social Welfare; Spiral Computed Tomography; Structure; Survey Methodology; Surveys; Target Populations; Techniques; Testing; Uncertainty; United States; Work; X-Ray Computed Tomography; cost; experience; health organization; high risk; innovation; instrument; interest; lung cancer screening; mortality; patient oriented; population health; preference; programs; public health relevance; tool

DESCRIPTION (provided by applicant): Lung cancer is a leading cause of cancer death in the United States, with an estimated 161,840 deaths in 2008. The popularity and availability of lung cancer screening has increased in the United States, despite controversy between advocates of screening and those who believe the efficacy of screening is unproven. There has been extensive media coverage of CT screening trials such as the I-ELCAP, NLST and NELSON trials. In addition, there has been media coverage of new screening methodologies such as genetic and lung serum testing. Nevertheless, there is no agreement on whether screening will reduce lung cancer mortality, and screening carries risks. As screening procedures become better known and more widely available, more individuals will face difficult decisions about whether to be screened for lung cancer and by what method. For such situations, informed decision making is critical, but little is currently known about what factors are important to individuals in making decisions about lung cancer screening. The long term goal of this line of research is to develop an informed decision making aid for lung cancer screening among asymptomatic high risk individuals. The specific objective of this application is to develop and explore a conjoint survey instrument that can be used to collect information on screening attributes that affect decisions about lung cancer screening. The conjoint methodology is an innovative approach to preference elicitation and its use in health care research has been increasing in recent years. The primary aims of this research are to: (1) Determine the range of process and outcome attributes of lung cancer screening that affect interest in being screened for lung cancer and develop and pilot test a conjoint survey instrument to evaluate these attributes; (2) Determine the importance and utility of each of the lung cancer screening scenario attributes; and (3) Determine the association of individual characteristics with interest in screening. To accomplish these aims we will first conduct semi-structured interviews with the target population and health care providers to gain information on the attributes of various lung cancer screening examinations that are important in individuals' screening decisions. We will use Sawtooth Software to develop a conjoint survey instrument and compile a survey which also includes various individual characteristics that also may be associated with screening interest. We will pilot test this survey using cognitive interviewing techniques, and then conduct a preliminary survey via a nationally representative web-based survey. The survey instrument developed in this research will then be used in future research which will have as its aim the development of a lung cancer decision aid that can be tailored to individual characteristics. The conjoint instrument will be an essential part of the decision aid as it helps individuals focus their preferences and facilitates decision making in complex, multi-attribute situations. PUBLIC HEALTH RELEVANCE: Lung cancer will lead to over 160,000 deaths in the United States in 2008. Screening for lung cancer may have the potential to shift diagnoses to an earlier stage where cancer is more treatable. However, given the uncertainty of screening benefits and significant risks, patient centered informed decision making about screening is critical. This research will allow us to develop an individually-tailored informed decision making aid to promote informed decision making about lung cancer screening, and lead to improvements in patient satisfaction and welfare.

描述（由申请人提供）：肺癌是美国癌症死亡的主要原因，2008年估计有161，840例死亡。肺癌筛查的普及和可用性在美国有所增加，尽管筛查的倡导者和那些认为筛查的有效性未经证实的人之间存在争议。媒体广泛报道了CT筛查试验，如I-ELCAP、NLST和纳尔逊试验。此外，媒体还报道了基因和肺血清检测等新的筛查方法。尽管如此，对于筛查是否会降低肺癌死亡率还没有达成一致意见，筛查也有风险。随着筛查程序越来越为人所知，越来越多的人将面临是否接受肺癌筛查以及采用何种方法的困难决定。在这种情况下，知情决策是至关重要的，但目前还不知道什么因素是重要的个人在肺癌筛查决策。这项研究的长期目标是为无症状高危人群的肺癌筛查开发一种知情的决策辅助工具。本申请的具体目标是开发和探索一种联合调查工具，可用于收集有关影响肺癌筛查决策的筛查属性的信息。联合方法是一种创新的方法，偏好诱导和它的使用在卫生保健研究中已经越来越多，近年来。 本研究的主要目的是：（1）确定过程和结果的范围 （2）确定每个肺癌筛查情景属性的重要性和效用;以及（3）确定个体特征与筛查兴趣的关联。为了实现这些目标，我们将首先与目标人群和医疗保健提供者进行半结构化访谈，以获得有关各种肺癌筛查检查的属性的信息，这些属性对个人的筛查决策很重要。我们将使用Sawtooth软件开发一个联合调查工具，并编制一份调查，其中还包括可能与筛选兴趣相关的各种个人特征。我们将使用认知访谈技术对该调查进行试点测试，然后通过具有全国代表性的网络调查进行初步调查。在这项研究中开发的调查工具将用于未来的研究，其目的是开发一种可以根据个人特点定制的肺癌决策辅助工具。联合工具将是决策辅助的重要组成部分，因为它可以帮助个人集中他们的偏好，并促进在复杂的多属性情况下的决策。 公共卫生相关性：2008年，肺癌将导致美国超过16万人死亡。肺癌筛查可能有可能将诊断转移到癌症更容易治疗的早期阶段。然而，考虑到筛查益处和重大风险的不确定性，以患者为中心的知情决策至关重要。这项研究将使我们能够开发一种个性化的知情决策辅助工具，以促进肺癌筛查的知情决策，并提高患者的满意度和福利。