دورية أكاديمية
أعرض في EDS

Aid-assisted decision making and colorectal cancer screening: a randomized controlled trial.

التفاصيل البيبلوغرافية
العنوان: Aid-assisted decision making and colorectal cancer screening: a randomized controlled trial.
المؤلفون: Schroy PC 3rd; Department of Medicine, Boston University, Boston, MA, USA. paul.schroy@bmc.org, Emmons KM, Peters E, Glick JT, Robinson PA, Lydotes MA, Mylvaganam SR, Coe AM, Chen CA, Chaisson CE, Pignone MP, Prout MN, Davidson PK, Heeren TC
المصدر: American journal of preventive medicine [Am J Prev Med] 2012 Dec; Vol. 43 (6), pp. 573-83.
نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 8704773 Publication Model: Print Cited Medium: Internet ISSN: 1873-2607 (Electronic) Linking ISSN: 07493797 NLM ISO Abbreviation: Am J Prev Med Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Elsevier Science
Original Publication: [New York, NY] : Oxford University Press, [c1985-
مواضيع طبية MeSH: Decision Making* , Decision Support Techniques*, Colorectal Neoplasms/*diagnosis , Mass Screening/*methods, Aged ; Community Health Centers ; Female ; Hospitals, Urban ; Humans ; Logistic Models ; Male ; Middle Aged ; Patient Acceptance of Health Care ; Risk Assessment/methods
مستخلص: Background: Shared decision making (SDM) is a widely recommended yet unproven strategy for increasing colorectal cancer (CRC) screening uptake. Previous trials of decision aids to increase SDM and CRC screening uptake have yielded mixed results.
Purpose: To assess the impact of decision aid-assisted SDM on CRC screening uptake.
Design: RCT.
Setting/participants: The study was conducted at an urban, academic safety-net hospital and community health center between 2005 and 2010. Participants were asymptomatic, average-risk patients aged 50-75 years due for CRC screening.
Intervention: Study participants (n=825) were randomized to one of two intervention arms (decision aid plus personalized risk assessment or decision aid alone) or control arm. The interventions took place just prior to a routine office visit with their primary care providers.
Main Outcome Measures: The primary outcome was completion of a CRC screening test within 12 months of the study visit. Logistic regression was used to identify predictors of test completion and mediators of the intervention effect. Analysis was completed in 2011.
Results: Patients in the decision-aid group were more likely to complete a screening test than control patients (43.1% vs 34.8%, p=0.046) within 12 months of the study visit; conversely, test uptake for the decision aid and decision aid plus personalized risk assessment arms was similar (43.1% vs 37.1%, p=0.15). Assignment to the decision-aid arm (AOR=1.48, 95% CI=1.04, 2.10), black race (AOR=1.52, 95% CI=1.12, 2.06) and a preference for a patient-dominant decision-making approach (AOR=1.55, 95% CI=1.02, 2.35) were independent determinants of test completion. Activation of the screening discussion and enhanced screening intentions mediated the intervention effect.
Conclusions: Decision aid-assisted SDM has a modest impact on CRC screening uptake. A decision aid plus personalized risk assessment tool is no more effective than a decision aid alone.
Trial Registration: This study is registered at www.clinicaltrials.govNCT00251862.
(Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: K05 CA129166 United States CA NCI NIH HHS; R01 HS013912 United States HS AHRQ HHS; K05CA129166 United States CA NCI NIH HHS; R01HS013912 United States HS AHRQ HHS
سلسلة جزيئية: ClinicalTrials.gov NCT00251862
تواريخ الأحداث: Date Created: 20121120 Date Completed: 20130501 Latest Revision: 20211021
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC3966107
DOI: 10.1016/j.amepre.2012.08.018
PMID: 23159252
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-2607
DOI:10.1016/j.amepre.2012.08.018