An Online Decision Aid for Patients With Metastatic Melanoma—Results of the Randomized Controlled Trial “PEF-Immun”.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Pia Grabbe, Milena S Borchers, Kathrin M Gschwendtner, Sophia Strobel, Beate Wild, Marietta Kirchner, Katharina Kälber, Adriana Rendon, Julian Steininger, Friedegund Meier, Jessica C Hassel, Christiane Bieber
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引用次数: 0

Abstract

Background: Treatment decisions in metastatic melanoma (MM) are highly dependent on patient preferences and require the patients' involvement. The complexity of treatment options with their individual advantages and disadvantages is often overwhelming. We therefore developed an online patient decision aid (PtDA) to facilitate shared decision making (SDM).

Methods: To evaluate the PtDA we conducted a two-armed, twocenter, prospective, open randomized controlled trial with MM patients who were facing a decision about first-line treatment. The patients were allotted randomly in a 1:1 ratio to an intervention group (IG) with access to the PtDA before discussion with a physician or to a control group (CG) without access to the PtDA. The primary endpoint was knowledge about the options for first-line treatment (multiple-choice test, 10 items, range 0-40 points). The secondary endpoints were the SDM (third-party ratings of audio recordings of the treatment discussions) and satisfaction with the decision at the follow-up visit.

Results: Of the 128 randomized patients, 120 completed the baseline questionnaire and were analyzed (59% male, median age 66 years). The primary endpoint, i.e., the mean difference in knowledge after discussion with a physician, differed significantly between the IG and the CG (-3.22, 95% CI [-6.32; -0.12], p = 0.042). No differences were found for the secondary endpoints, SDM and satisfaction with the decision. The patients in the IG rated the PtDA as very useful.

Conclusion: The PtDA improved the knowledge of patients with MM about the options for treatment. Both groups were highly satisfied with their treatment decisions. However, additional physician training seems necessary to promote SDM.

转移性黑色素瘤患者在线决策辅助工具--随机对照试验 "PEF-Immun "的结果。
背景:转移性黑色素瘤(MM)的治疗决策取决于患者的偏好,需要患者参与决策过程。面对复杂的治疗方案及其各自的优缺点,患者往往感到不知所措。我们开发了一种在线患者决策辅助工具(PtDA),以促进共同决策(SDM):我们在两个中心开展了一项双臂、前瞻性、开放式随机对照试验,对象是面临一线治疗决策的 MM 患者。在与医生讨论治疗选择之前,他们被随机分配(1:1)使用或不使用 PtDA(分别为干预组[IG]和对照组[CG])。研究的主要终点是患者对一线治疗方案的了解程度(多项选择测试,10 个项目,0-40 分不等)。次要终点是 SDM 的程度(由第三方观察员对患者与医生讨论的录音进行评分)以及对日后随访所做决定的满意度:128 名随机抽取的患者中有 120 人完成了基线问卷并纳入分析(59% 为男性,中位年龄为 66 岁)。主要终点,即与医生讨论后知识的平均差异,干预组明显高于对照组(平均差异-3.22,95% CI [-6.32;-0.12],P = 0.042)。在次要终点(SDM 和对决定的满意度)方面没有发现差异。干预组患者认为PtDA非常有用:PtDA提高了MM患者对治疗方案的了解。结论:PtDA 增进了 MM 患者对治疗方案的了解,使用和未使用 PtDA 的患者都对自己的治疗决定非常满意。看来有必要对医生进行更多培训,以促进 SDM。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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