"It all depends on why it's red": qualitative interviews exploring patient and professional views of a traffic light system for IVF add-ons.

Sarah Lensen, Sarah Armstrong, Emily Vaughan, Lucy Caughey, Michelle Peate, Cynthia Farquhar, Allan Pacey, Adam H Balen, Elaine Wainwright
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引用次数: 1

Abstract

Background IVF add-ons are techniques, medicines or procedures used in addition to standard IVF with the aim of improving the chance of success. The United Kingdom's IVF regulator, ( the Human Fertilisation Embryology Authority (HFEA) developed a traffic light system to categorise add-ons as either green, amber, or red, based on results of randomised controlled trials. Method Qualitative interviews were undertaken to explore understanding and views of the HFEA traffic light system among IVF clinicians, embryologists and IVF patients across Australia and the United Kingdom. Results A total of 73 interviews were conducted. Overall, participants were supportive of the intention of the traffic light system, however many limitations were raised. It was widely recognized that a simple traffic light system necessarily omits information which may be important to understanding the evidence base. In particular, the red category was used in scenarios that patients viewed as having different implications for their decision-making, including 'no evidence' and 'evidence of harm'. Patients were surprised at the absence of any green add-ons and questioned the value of a traffic light system in this context. Many participants considered the website a helpful starting point, but desired more detail, including the contributing studies, results specific to patient demographics (e.g., <35 years and >35 years), and inclusion of more options (e.g. acupuncture). Overall, participants believed the website to be reliable and trustworthy, particularly due to the Government affiliation, and despite some concerns regarding transparency and an overly cautious regulator. Conclusion Participants identified many limitations with the current application of the traffic light system. These could be considered in any future updates to the HFEA website and for others developing similar decision support tools.

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“这完全取决于它为什么是红色的”:定性访谈探讨了试管婴儿附加装置的红绿灯系统的患者和专业人士的观点。
体外受精附加技术是在标准体外受精之外使用的技术、药物或程序,目的是提高成功的机会。英国试管婴儿监管机构人类受精胚胎学管理局(HFEA)开发了一种红绿灯系统,根据随机对照试验的结果,将附加物分为绿色、琥珀色或红色。方法采用定性访谈法,探讨澳大利亚和英国试管婴儿临床医生、胚胎学家和试管婴儿患者对HFEA红绿灯系统的理解和看法。结果共进行了73次访谈。总体而言,与会者都支持交通灯系统的意图,但提出了许多限制。人们普遍认识到,一个简单的交通灯系统必然会忽略可能对理解证据基础很重要的信息。特别是,红色类别用于患者认为对其决策有不同影响的情况,包括“无证据”和“有伤害的证据”。病人对没有任何绿色附加设施感到惊讶,并质疑在这种情况下交通灯系统的价值。许多参与者认为该网站是一个有用的起点,但需要更多的细节,包括贡献研究,特定于患者人口统计(例如,35岁)的结果,并包括更多的选择(例如针灸)。总体而言,参与者认为该网站是可靠和值得信赖的,特别是由于与政府的关系,尽管有些人担心透明度和过于谨慎的监管机构。结论:与会者认为交通灯系统目前的应用存在许多局限性。这些可以在未来更新HFEA网站和开发类似决策支持工具的其他人时考虑。
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