Leena Nahata, Charleen I Roche, Megan M Griffith, Tanvi Karkare, Gwendolyn P Quinn, Sarah H O'Brien, Kelly Boone, Anthony Audino, Nicholas Yeager, Stacy Whiteside, Jennifer English, James L Klosky, Joseph R Rausch, Cynthia A Gerhardt
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Differences in decision quality by banking attempt were explored.</p><p><strong>Design/methods: </strong>Males (12-25 years, new cancer diagnosis) and caregivers were randomized to standard of care (fertility consult) or FP-DAD (fertility consult + FAST + interventionist-led discussion). One month later, FP-DAD participants completed acceptability surveys. Both arms completed the Brief Subjective Decision Quality measure. Descriptive statistics, chi-square, and independent samples t-tests/mixed-models examined relationships between variables.</p><p><strong>Results: </strong>Acceptability ratings of FP-DAD were high (88%-100%). Recruitment and participation challenges limited the final sample size (21 adolescents and 32 caregivers). Banking attempts (67% in standard of care vs. 82% in FP-DAD) did not differ by arm. While decision quality was not significantly different between groups, effect sizes were medium-large for four of six items for adolescents (d = 0.6 to -0.90) and two of six for caregivers (d = 0.36 to -0.78). Decision quality was significantly higher across several domains among those who banked.</p><p><strong>Conclusions: </strong>FP-DAD had high acceptability, though feasibility challenges (e.g., time contraints) limited full family participation. Findings showed limited efficacy, but effect sizes suggest this may be due to sample size. Relationships between banking attempts and decision quality emphasize banking benefits. 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引用次数: 0
摘要
背景/目的：开发以家庭为中心的青少年精子库价值澄清工具（FAST），以促进精子库的沟通和癌前治疗决策。FAST在一项平行随机对照试验中进行了测试（生育保留讨论和决定：“FP-DAD”-NCT04268004），旨在(i)评估FP-DAD的可行性/可接受性；（ii）检验银行尝试的有效性（是/否）和决策质量。探讨了银行尝试对决策质量的影响。设计/方法：男性（12-25岁，新癌症诊断）和护理人员随机分为标准护理组（生育咨询）或FP-DAD组（生育咨询+ FAST +介入医生主导的讨论）。一个月后，FP-DAD参与者完成了可接受性调查。两组都完成了简要主观决策质量测量。描述性统计、卡方和独立样本t检验/混合模型检验了变量之间的关系。结果：FP-DAD可接受度高（88% ~ 100%）。招募和参与方面的挑战限制了最终样本量（21名青少年和32名照顾者）。银行尝试（标准护理组67% vs FP-DAD组82%）各组间无差异。虽然决策质量在两组之间没有显着差异，但青少年的六个项目中的四个（d = 0.6至-0.90）和照顾者的六个项目中的两个（d = 0.36至-0.78）的效应量均为中大型。那些有银行业务的人在多个领域的决策质量明显更高。结论：FP-DAD具有较高的可接受性，尽管可行性挑战（如时间限制）限制了整个家庭的参与。研究结果显示，效果有限，但效应量表明，这可能是由于样本量。银行尝试和决策质量之间的关系强调银行利益。研究结果将为临床实施FAST的调整提供信息。
Fertility Preservation Discussions And Decisions: Results From a Pilot Randomized Controlled Trial Among Adolescent Males With Cancer.
Background/objectives: The Family-centered Adolescent Sperm banking values clarification Tool (FAST) was developed to facilitate sperm banking communication and decision-making pre-cancer treatment. The FAST was tested in a pilot parallel randomized controlled trial (Fertility Preservation Discussions And Decisions: "FP-DAD"-NCT04268004), aiming to (i) assess feasibility/acceptability of FP-DAD; and (ii) examine efficacy regarding banking attempts (yes/no) and decision quality. Differences in decision quality by banking attempt were explored.
Design/methods: Males (12-25 years, new cancer diagnosis) and caregivers were randomized to standard of care (fertility consult) or FP-DAD (fertility consult + FAST + interventionist-led discussion). One month later, FP-DAD participants completed acceptability surveys. Both arms completed the Brief Subjective Decision Quality measure. Descriptive statistics, chi-square, and independent samples t-tests/mixed-models examined relationships between variables.
Results: Acceptability ratings of FP-DAD were high (88%-100%). Recruitment and participation challenges limited the final sample size (21 adolescents and 32 caregivers). Banking attempts (67% in standard of care vs. 82% in FP-DAD) did not differ by arm. While decision quality was not significantly different between groups, effect sizes were medium-large for four of six items for adolescents (d = 0.6 to -0.90) and two of six for caregivers (d = 0.36 to -0.78). Decision quality was significantly higher across several domains among those who banked.
Conclusions: FP-DAD had high acceptability, though feasibility challenges (e.g., time contraints) limited full family participation. Findings showed limited efficacy, but effect sizes suggest this may be due to sample size. Relationships between banking attempts and decision quality emphasize banking benefits. Findings will inform adaptations to the FAST for clinical implementation.
期刊介绍：
Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.
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