Role of decision aid desgin in single event decision making

决策辅助设计在单事件决策中的作用

• 批准号: 7613081
• 负责人: ANGELA FAGERLIN
• 金额: $ 14.43万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7613081
• 关键词: Attention; Attitude; Awareness; Benefits and Risks; Biopsy; Cancer Patient; Chemoprevention; Clinical; Communication; Conflict (Psychology); Data; Decision Aid; Decision Making; Educational process of instructing; Effectiveness; Equilibrium; Eye; Face; Goals; Health; Healthcare; High Risk Woman; Impotence; Incidence; Internet; Intervention; Knowledge; Localized; Malignant Neoplasms; Malignant neoplasm of prostate; Mastectomy; Medical; Methods; Michigan; Newly Diagnosed; Numbers; Operative Surgical Procedures; Outcome; Outcome Measure; Patient Preferences; Patient observation; Patients; Perception; Persons; Phase; Physicians; Play; Process; Prostate; Purpose; Qualitative Methods; Quality of life; Radiation; Raloxifene; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recommendation; Recruitment Activity; Regrets; Research; Risk; Role; Sampling; Self Efficacy; Standards of Weights and Measures; Surveys; Tamoxifen; Techniques; Testing; Thinking; Time; University Hospitals; Urologist; Visit; Woman; anticancer research; breast lumpectomy; cancer care; cancer therapy; design; desire; experience; improved; malignant breast neoplasm; man; men; novel; preference; prevent; psychological outcomes; research study; satisfaction; therapy design; trial comparing; willingness

Promoting Shared Decision Making Through a Tailored Decision Aid PROJECT SUMMARY Many medical decisions are preference-sensitive, with the best choice depending in part on patient attitudes towards the risks and benefits of treatment alternatives. For example, the best treatment for a man with localized prostate cancer may depend on how strongly he wants to avoid the chance of impotence, or on how determined he is to physically remove the cancer from his body. An ideal decision, therefore, will be made with full awareness of patient preferences. Research is needed to determine the best methods for helping patients communicate their preferences to their physicians. Using a two-phase strategy, we will test methods for increasing patients' willingness and ability to discuss their preferences and for improving the concordance between their desires for shared decision making and the type of participation they experience. In Phase I, we will conduct Internet studies to test several novel ways of tailoring a prostate cancer decision aid (DA), with the goal of identifying interventions that increase the perceived salience of patient preferences. After we have determined the best interventions, we will modify our current prostate cancer DA accordingly. Phase II will then compare this new tailored DA to our current untailored decision aid in men with newly diagnosed localized prostate cancer. This study will be conducted at two hospitals (University of Michigan and Ann Arbor VA) and will recruit men at the time of their prostate biopsy. Effectiveness of the tailored DA will be determined using both quantitative and qualitative methods. Primary quantitative outcome measures include self-efficacy and intentions for communicating treatment preferences to physician, preference for participating in the decision, concordance of desired and actual participation in the decision, and patients' perceptions of their interaction with their physicians. We will also analyze conversations between patients and physicians to examine whether the tailored DA has an impact on the interaction between patients and physicians (e.g., discussion of patients' preferences). Finally, we will use eye-tracking studies as another method of accessing patient engagement with the DA. The results of this study allow us to have unprecedented data about how to design DAs to improve patient-physician communication. This will result in patients making more informed decisions, which in turn could result in better physical and psychological outcomes for patients.

通过定制决策辅助促进共同决策 项目概要 许多医疗决策都对偏好敏感，最佳选择部分取决于患者的态度 了解治疗替代方案的风险和益处。例如，对于患有以下疾病的男性来说，最好的治疗方法是： 局限性前列腺癌可能取决于他想要避免阳痿机会的强烈程度，或者取决于他如何避免 他下定决心要从身体上去除癌症。因此，理想的决定将是 充分了解患者的喜好。需要进行研究以确定帮助患者的最佳方法 将他们的偏好传达给他们的医生。使用两阶段策略，我们将测试方法 提高患者讨论他们的偏好并提高一致性的意愿和能力 他们对共同决策的渴望和他们所经历的参与类型之间的关系。在第一阶段，我们 将进行互联网研究，以测试几种定制前列腺癌决策辅助 (DA) 的新方法，其中 目标是确定增加患者偏好感知显着性的干预措施。之后我们有 确定了最佳干预措施后，我们将相应地修改当前的前列腺癌 DA。随后第二阶段将 将这种新的定制 DA 与我们目前针对新诊断的局部男性的未定制的决策辅助进行比较 前列腺癌。这项研究将在两家医院（密歇根大学和弗吉尼亚州安娜堡分校）进行 将在进行前列腺活检时招募男性。定制 DA 的有效性将通过以下方式确定 定量和定性方法。主要的定量结果指标包括自我效能感和 向医生传达治疗偏好的意图、参与决策的偏好， 期望和实际参与决策的一致性，以及患者对其互动的看法 和他们的医生。我们还将分析患者和医生之间的对话，以检查是否 定制的 DA 会影响患者和医生之间的互动（例如，讨论患者的问题） 偏好）。最后，我们将使用眼动追踪研究作为了解患者参与度的另一种方法 与DA。这项研究的结果使我们能够获得有关如何设计 DA 的前所未有的数据 改善医患沟通。这将导致患者做出更明智的决定，从而 转变可以为患者带来更好的身体和心理结果。