{"title":"反复扁桃体炎的决策辅助试验。","authors":"Callum Hill, Kim Ah-See, Helen Moffat","doi":"10.1111/coa.14278","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Currently, there is no adult-specific decision aid (DA) to support decision-making regarding recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA.</p><p><strong>Design: </strong>Randomised clinical trial.</p><p><strong>Setting: </strong>Single centre trial at a tertiary otolaryngology department.</p><p><strong>Participants: </strong>Forty-three patients were randomised to either the DA or Treatment as Usual (TAU) group.</p><p><strong>Main outcome measures: </strong>Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow-up (SURE scale).</p><p><strong>Secondary objective: </strong>The level of decisional satisfaction at the time of the decision and follow-up, as well as to explore the numbers of people opting for surgery for each study condition (Shared tool and patient feedback).</p><p><strong>Results: </strong>Quality: This study demonstrates no statistically significant difference in how patients rate the quality of their treatment decision between DA and TAU, both at baseline (p = 0.553) and follow-up (p = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the Shared tool (U = 113, p = 0.026). No other significant difference was found between participants who received the DA and TAU.</p><p><strong>Conclusion: </strong>The DA is an acceptable and useful tool that could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that including the DA improves the quality of decision-making.</p><p><strong>Trial registration: </strong>IRAS ID - 230 362.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Piloting of a Decision Aid for Recurrent Tonsillitis.\",\"authors\":\"Callum Hill, Kim Ah-See, Helen Moffat\",\"doi\":\"10.1111/coa.14278\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Currently, there is no adult-specific decision aid (DA) to support decision-making regarding recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA.</p><p><strong>Design: </strong>Randomised clinical trial.</p><p><strong>Setting: </strong>Single centre trial at a tertiary otolaryngology department.</p><p><strong>Participants: </strong>Forty-three patients were randomised to either the DA or Treatment as Usual (TAU) group.</p><p><strong>Main outcome measures: </strong>Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow-up (SURE scale).</p><p><strong>Secondary objective: </strong>The level of decisional satisfaction at the time of the decision and follow-up, as well as to explore the numbers of people opting for surgery for each study condition (Shared tool and patient feedback).</p><p><strong>Results: </strong>Quality: This study demonstrates no statistically significant difference in how patients rate the quality of their treatment decision between DA and TAU, both at baseline (p = 0.553) and follow-up (p = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the Shared tool (U = 113, p = 0.026). No other significant difference was found between participants who received the DA and TAU.</p><p><strong>Conclusion: </strong>The DA is an acceptable and useful tool that could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that including the DA improves the quality of decision-making.</p><p><strong>Trial registration: </strong>IRAS ID - 230 362.</p>\",\"PeriodicalId\":10431,\"journal\":{\"name\":\"Clinical Otolaryngology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-01-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Otolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/coa.14278\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/coa.14278","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：目前，还没有成人专用的决策辅助（DA）来支持复发性扁桃体炎的决策。本研究打算通过试点原型数据处理来解决这一差距。设计：随机临床试验。背景：在第三耳鼻喉科进行单中心试验。参与者：43名患者被随机分为DA组或常规治疗组（TAU）。主要结果测量：主要目的：测量患者在决策时和随访时对其决策经验质量的评价（SURE量表）。次要目标：决策和随访时的决策满意度水平，以及探索每个研究条件下选择手术的人数（共享工具和患者反馈）。结果：质量：本研究显示DA和TAU患者对治疗决策质量的评价在基线（p = 0.553）和随访（p = 0.062）时均无统计学差异。满意度：该研究显示，在为共享工具的Qu2做出决策时，决策满意度的统计显著水平（U = 113, p = 0.026）。在接受DA和TAU的参与者之间没有发现其他显著差异。结论：DA是一种可接受和有用的工具，可纳入复发性扁桃体炎的途径，有助于消除医生的内隐偏倚。然而，本试点研究的初步定性证据并不表明纳入DA可以提高决策质量。试验注册：IRAS ID - 230 362。
Piloting of a Decision Aid for Recurrent Tonsillitis.
Objective: Currently, there is no adult-specific decision aid (DA) to support decision-making regarding recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA.
Design: Randomised clinical trial.
Setting: Single centre trial at a tertiary otolaryngology department.
Participants: Forty-three patients were randomised to either the DA or Treatment as Usual (TAU) group.
Main outcome measures: Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow-up (SURE scale).
Secondary objective: The level of decisional satisfaction at the time of the decision and follow-up, as well as to explore the numbers of people opting for surgery for each study condition (Shared tool and patient feedback).
Results: Quality: This study demonstrates no statistically significant difference in how patients rate the quality of their treatment decision between DA and TAU, both at baseline (p = 0.553) and follow-up (p = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the Shared tool (U = 113, p = 0.026). No other significant difference was found between participants who received the DA and TAU.
Conclusion: The DA is an acceptable and useful tool that could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that including the DA improves the quality of decision-making.
期刊介绍：
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
