COMputerized PAtient-centered Collaborative Technology (COMPACT) to Support Personalized Decision Making in Breast Cancer

项目总结 这项拟议的研究解决了支持乳腺癌个性化治疗的迫切需要 根据每个患者的独特需求、价值观和偏好做出决策。乳腺癌是 妇女中最常见的癌症，每年约有28万新确诊病例。乳腺癌 治疗决定是复杂的，因为通常有几种临床上可行的治疗选择，每一种 具有不同的风险、益处和对患者生活的影响。让病人参与进来是很重要的 偏好敏感的决定，然而，大约50%的乳腺癌患者不知情 关于治疗的决定，患者报告只知道与决定相关的信息的一半。 对治疗决策过程的理解不足或参与不足可能导致效果不佳。 患者结果、患者满意度降低以及更高的医疗成本。我们建议一个计算机化的 以患者为中心的协作技术(COMPACT)，采用人因工程(HFE)设计 方法，可以改善个性化的乳腺癌决策和患者预后。在此期间，4- 在今年的项目中，我们将使用人性化设计(HCD)来设计和测试紧凑型系统。 这项研究将支持PI向研究独立性的过渡，并推动她实现 她的长期目标是成为增强的HFE设计和实施领域的领导者 支持癌症护理团队合作的智能技术。这项研究将在强大的 范德比尔特大学医学中心的制度环境。凭借她在HFE设计方面的专业知识 健康信息技术(HIT)，她将发展(1)乳腺癌护理的基本知识和技能， (2)患者命中设计；(3)实施科学性。PI将提高这些技能，目标如下： 研究目标一是深入分析HFE工作系统，以了解社会技术工作系统 乳癌护理发生的地方。对患者及其家庭照顾者的访谈和观察 临床医生将生成详细的护理流程地图和患者旅程地图，以支持设计 紧凑型。私人助理将获得有关癌症护理流程和乳腺癌患者需求的知识。 研究目标2是COMPACT的HCD。利用AIM 1的调查结果，我们将进行一系列合作 设计与患者、他们的护理人员和临床医生的会议，以开发紧凑的用户界面。 形成性可用性测试和启发式评估将确定原型的设计改进。这个 PI将发展面向患者的HIT和实施科学方面的技能。 研究目标3是在基于场景的仿真中对COMPACT进行评估。基于场景的 使用COMPACT对潜在的乳腺癌患者和临床医生(单独和分组)进行模拟 在现实条件下，将评估COMPACT的潜在有用性、可用性和接受度。 未来的工作将在随机对照试验中研究COMPACT，以了解其对患者护理的影响。

PROJECT SUMMARY The proposed research addresses an urgent need to support personalized breast cancer treatment decision making based on the unique needs, values, and preferences of each patient. Breast cancer is the most common cancer in women, with approximately 280,000 new cases diagnosed each year. Breast cancer treatment decisions are complex as there are often several clinically viable treatment options available, each with differing risks, benefits, and implications on the patient’s life. It is important to involve patients in this preference-sensitive decision, yet, approximately 50% of breast cancer patients do not make informed decisions regarding treatment, and patients report only knowing half of the information relevant to the decision. Poor understanding or insufficient participation in the treatment decision making process can lead to poor patient outcomes, reduced patient satisfaction, and higher healthcare costs. We propose that a COMputerized PAtient-centered Collaborative Technology (COMPACT), designed with Human Factors Engineering (HFE) approaches, can improve personalized breast cancer decision making and patient outcomes. During this 4- year project, we will design and test the COMPACT system using human centered design (HCD). This research will support the PIs transition to research independence and propel her towards achieving her long-term goal of becoming a leader in the field of HFE design and implementation of augmented intelligence technologies to support teamwork in cancer care. The research will take place in the strong institutional environment at Vanderbilt University Medical Center. Building on her expertise in HFE design of health information technology (HIT), she will develop essential knowledge and skills in (1) breast cancer care, (2) design of patient HIT, and (3) implementation science. The PI will grow these skills with the following Aims: Research Aim 1 is a thorough HFE work system analysis to understand the sociotechnical work system in which breast cancer care occurs. Interviews with and observations of patients, their family caregivers, and clinicians will generate detailed care process maps and patient journey maps to support the design of COMPACT. The PI will gain knowledge on cancer care processes and the needs of breast cancer patients. Research Aim 2 is the HCD of COMPACT. Using Aim 1 findings, we will conduct a series of collaborative design sessions with patients, their caregivers, and clinicians to develop the COMPACT user interfaces. Formative usability testing and a heuristic evaluation will identify design improvements to the prototypes. The PI will develop skills in patient-facing HIT and implementation science. Research Aim 3 is the evaluation of COMPACT in a scenario-based simulation. Scenario-based simulations with potential breast cancer patients and clinicians (individually and in groups) using COMPACT under realistic conditions will evaluate COMPACT’s potential usefulness, usability, and acceptance. Future work will study COMPACT in a randomized controlled trial to understand its impact on patient care.