BREAST CANCER GENE EDUCATION--COMPUTER VS PRACTITIONER

描述：(申请人摘要)拟议研究的目标 就是确定基于计算机的教育是否像 以实践者为基础的教育，以增加对遗传的了解 检测乳腺癌。让患者在知情的情况下做出选择 乳腺癌的遗传易感性测试，他们需要信息 关于检测结果的意义，筛查的风险和好处， 基因评估的替代方案，以及阳性患者的选择 测试结果。这对于遗传易感性来说尤其重要。 对于乳腺癌，自提出“治疗方案”以来，检测结果呈阳性 结果(如预防性双侧乳房切除术)是侵入性的， 影响深远，而且未经证实。尽管需要事先提供信息 为了筛查，一对一的教育是昂贵的，初级保健从业者 不太可能有时间或专业知识来咨询 乳腺癌基因和遗传咨询师都很稀缺。 从业者可以使用低成本、有效、可靠和可接受的 提供有关乳腺癌基因筛查的信息的方法 对病人来说。在其他情况下，计算机已被成功地使用 传播医疗信息。然而，目前尚不清楚， 基因教育的计算机方法可以有效地帮助患者 在乳腺癌基因筛查方面做出明智的选择。 主要的研究假设是，在一项测试中的理解分数 即时回忆有关乳房基因筛查的资料 接受计算机教育的患者罹患癌症的几率也会同样高 以实践者为基础的教育。第二个假设是 知识会影响接受测试意向和以计算机为基础 与实践者教育相比，教育的成本更低。我们将测试 这些假说是通过随机对照临床试验得出的， 两个研究地点的家族性乳腺癌高危妇女。 同意的符合条件的受试者将被随机接受 通过计算机或遗传咨询师进行教育。紧随其后 在教育干预中，受试者将被给予多项选择 理解力测试。这项测试的分数将被测量，并分组 我们将对这些方法进行比较。接受乳腺癌检测的意向 在教育前后进行易感基因检测 并将结果进行比较，以评估干预的效果 对接受基因筛查的意向的了解。计算机的成本- 以人为本的教育将被比作以实践者为基础的教育。

DESCRIPTION: (Applicant's Abstract) The objective of the proposed study is to determine whether computer-based education is as effective as practitioner-based education for increasing understanding of genetic testing for breast cancer. For patients to make informed choices about genetic susceptibility testing for breast cancer, they need information about the meaning of test results, risks and benefits of screening, alternatives to genetic evaluation, and options for those with positive test results. This is particularly important with genetic susceptibility to breast cancer, since some proposed "treatments" for positive test results (such as prophylactic bilateral mastectomy) are invasive, of profound impact, and unproven. Despite the need for information prior to screening, one-on-one education is costly, primary care practitioners are unlikely to have the time or specialized knowledge to counsel about the breast cancer gene, and genetic counselors are scarce. Practitioners could use a low cost, effective, reliable and acceptable method to provide information about genetic screening for breast cancer to patients. In other contexts, computers have been used successfully to disseminate medical information. It is not known, however, whether a computer approach to genetic education can effectively assist patients in making informed choices about genetic screening for breast cancer. The primary study hypothesis is that comprehension scores on a test of immediate recall of information about genetic screening for breast cancer will be as high for patients informed by computer-based education as by practitioner-based education. The secondary hypotheses are that knowledge will affect intent to receive testing and that computer-based education is less costly than practitioner-based education. We will test these hypotheses by a randomized controlled clinical trial using 150 women at high risk for familial breast cancer at two study sites. Consenting eligible subjects will be randomized to receive either education by computer or by genetic counselor. Immediately following the educational intervention, subjects will be given a multiple choice test of comprehension. Scores on this test will be measured, and group means will be compared. Intent to receive testing for the breast cancer susceptibility gene will be measured before and after the education intervention, and results will be compared to assess the effect of knowledge on intention to undergo genetic screening. Costs of computer- based education will be compared to practitioner-based education.