Development of a Conjoint Analysis Instrument for Lung Cancer Screening Decisions

肺癌筛查决策联合分析仪器的开发

基本信息

批准号：
8090509
负责人：
Margaret M Byrne
金额：
$ 16.5万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-15 至 2012-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8090509
关键词：
Address Advocate Affect Agreement Blood Cancer Etiology Cessation of life Characteristics Client satisfaction Cognitive Complex Computer software Decision Aid Decision Making Development Diagnosis Diagnostic Neoplasm Staging Diagnostic radiologic examination Dose Ensure Face Genetic Genetic Markers Goals Health Personnel Health Services Research Imaging Techniques Individual Interview Lead Lung Malignant neoplasm of lung Methodology Methods National Cancer Institute Nodule Online Systems Outcome Patients Persons Phase Process Public Health Recommendation Research Risk Sampling Screening procedure Serum Smoker Social Welfare Spiral Computed Tomography Structure Survey Methodology Surveys Target Populations Techniques Testing Uncertainty United States Work X-Ray Computed Tomography cost experience health organization high risk innovation instrument interest lung cancer screening mortality patient oriented population health preference programs public health relevance tool

项目摘要

DESCRIPTION (provided by applicant): Lung cancer is a leading cause of cancer death in the United States, with an estimated 161,840 deaths in 2008. The popularity and availability of lung cancer screening has increased in the United States, despite controversy between advocates of screening and those who believe the efficacy of screening is unproven. There has been extensive media coverage of CT screening trials such as the I-ELCAP, NLST and NELSON trials. In addition, there has been media coverage of new screening methodologies such as genetic and lung serum testing. Nevertheless, there is no agreement on whether screening will reduce lung cancer mortality, and screening carries risks. As screening procedures become better known and more widely available, more individuals will face difficult decisions about whether to be screened for lung cancer and by what method. For such situations, informed decision making is critical, but little is currently known about what factors are important to individuals in making decisions about lung cancer screening. The long term goal of this line of research is to develop an informed decision making aid for lung cancer screening among asymptomatic high risk individuals. The specific objective of this application is to develop and explore a conjoint survey instrument that can be used to collect information on screening attributes that affect decisions about lung cancer screening. The conjoint methodology is an innovative approach to preference elicitation and its use in health care research has been increasing in recent years. The primary aims of this research are to: (1) Determine the range of process and outcome attributes of lung cancer screening that affect interest in being screened for lung cancer and develop and pilot test a conjoint survey instrument to evaluate these attributes; (2) Determine the importance and utility of each of the lung cancer screening scenario attributes; and (3) Determine the association of individual characteristics with interest in screening. To accomplish these aims we will first conduct semi-structured interviews with the target population and health care providers to gain information on the attributes of various lung cancer screening examinations that are important in individuals' screening decisions. We will use Sawtooth Software to develop a conjoint survey instrument and compile a survey which also includes various individual characteristics that also may be associated with screening interest. We will pilot test this survey using cognitive interviewing techniques, and then conduct a preliminary survey via a nationally representative web-based survey. The survey instrument developed in this research will then be used in future research which will have as its aim the development of a lung cancer decision aid that can be tailored to individual characteristics. The conjoint instrument will be an essential part of the decision aid as it helps individuals focus their preferences and facilitates decision making in complex, multi-attribute situations. PUBLIC HEALTH RELEVANCE: Lung cancer will lead to over 160,000 deaths in the United States in 2008. Screening for lung cancer may have the potential to shift diagnoses to an earlier stage where cancer is more treatable. However, given the uncertainty of screening benefits and significant risks, patient centered informed decision making about screening is critical. This research will allow us to develop an individually-tailored informed decision making aid to promote informed decision making about lung cancer screening, and lead to improvements in patient satisfaction and welfare.

描述（由申请人提供）：肺癌是美国癌症死亡的主要原因，2008 年估计有 161,840 人死亡。尽管肺癌筛查的倡导者之间存在争议，但肺癌筛查的普及度和可用性在美国有所增加以及那些认为筛查效果尚未得到证实的人。媒体对 I-ELCAP、NLST 和 NELSON 试验等 CT 筛查试验进行了广泛报道。此外，媒体还报道了基因和肺血清检测等新的筛查方法。然而，对于筛查是否会降低肺癌死亡率尚未达成一致，而且筛查也存在风险。随着筛查程序变得更加广为人知且广泛应用，越来越多的人将面临是否接受肺癌筛查以及通过什么方法进行筛查的艰难决定。对于这种情况，做出明智的决策至关重要，但目前人们对哪些因素对个人做出肺癌筛查决策重要的因素知之甚少。该研究的长期目标是为无症状高危个体中的肺癌筛查开发明智的决策辅助工具。该应用程序的具体目标是开发和探索一种联合调查工具，可用于收集影响肺癌筛查决策的筛查属性信息。联合方法是一种创新的偏好诱导方法，近年来其在医疗保健研究中的使用不断增加。本研究的主要目的是： (1) 确定过程和结果的范围影响肺癌筛查兴趣的肺癌筛查属性，并开发和试点测试联合调查工具来评估这些属性； (2) 确定每个肺癌筛查场景属性的重要性和实用性； (3) 确定个体特征与筛查兴趣的关联。为了实现这些目标，我们将首先对目标人群和医疗保健提供者进行半结构化访谈，以获取有关各种肺癌筛查检查属性的信息，这些属性对个人的筛查决策很重要。我们将使用 Sawtooth 软件开发联合调查工具并编制调查，其中还包括也可能与筛选兴趣相关的各种个人特征。我们将使用认知访谈技术对这项调查进行试点测试，然后通过具有全国代表性的网络调查进行初步调查。本研究开发的调查工具将用于未来的研究，其目标是开发可根据个体特征定制的肺癌决策辅助工具。联合工具将成为决策辅助的重要组成部分，因为它可以帮助个人集中自己的偏好，并促进在复杂、多属性情况下的决策制定。公共卫生相关性： 2008 年，肺癌将导致美国超过 160,000 人死亡。肺癌筛查可能有可能将诊断转移到癌症更容易治疗的早期阶段。然而，鉴于筛查益处的不确定性和重大风险，以患者为中心的筛查决策至关重要。这项研究将使我们能够开发出个性化的知情决策辅助工具，以促进有关肺癌筛查的知情决策，并提高患者满意度和福利。