目的 系统评价决策辅助工具在局限性前列腺癌患者治疗中的应用效果.方法 计算机检索Cochrane Library、Web of Science、PubMed、Embase、Scopus、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中有关决策辅助工具在前列腺癌患者中应用效果的随机对照试验,检索时间为2000年1月至2023年1月.依据Cochrane手册5.1.0版进行文献质量评价,并用RevMan 5.4进行软件分析.结果 共纳入10篇研究,包括2 695例研究对象.Meta分析结果显示,决策辅助工具可改善局限性前列腺癌患者治疗决策冲突(MD=-0.85,95％CI:-0.56～-0.14,P=0.02),但对提高决策知识(SMD=0.56,95％CI:-0.06～1.18,P=0.08)、决策准备(SMD=0.08,95％CI:-0.24～0.40,P=0.61)、决策满意度(SMD=2.17,95％CI:-0.66～5.00,P=0.13)和降低决策后悔(SMD=0.33,95％CI:-1.09～1.75,P=0.65)无显著作用.结论 决策辅助工具对局限性前列腺癌患者治疗决策具有一定干预效果,但仍需更多高质量试验进一步验证.今后可借鉴国外相关理论框架及开发经验,研发符合我国患者需求的决策辅助工具,以提高患者的决策质量.
Application effect of decision aids in the treatment of localized prostate cancer patients:a systematic review
Objective To systematically evaluate the application effect of decision aids in the treatment of localized prostate cancer patients.Methods Databases of Cochrane Library,Web of Science,PubMed,Embase,Scopus,CNKI,VIP,Wanfang and CBM were retrieved from January 2000 to January 2023 for randomized controlled trial of the application effect of decision aids on prostate cancer patients.The quality of the literature was evaluated according to Cochrane manual 5.1.0 edition and analyzed by RevMan 5.4 software.Results A total of 10 randomized trials were included,covering 2,695 study subjects.Meta-analysis showed that:decision aids could improve treatment decision conflict(MD=-0.85,95％CI:-0.56--0.14,P=0.02)of localized prostate cancer patients,but improvement of decision knowledge(SMD=0.56,95％CI:-0.06-1.18.P=0.08),decision preparation(SMD=0.08,95％CI:-0.24-0.40,P=0.61),decision satisfaction(SMD=2.17,95％CI:-0.66-5.00,P=0.13)and reduction of decision regret(SMD=0.33,95％CI:-1.09-1.75,P=0.65)had no significant effect.Conclusions Decision aids have a certain intervention effect on the treatment decisions for patients with localized prostate cancer.However,more high-quality trials are still needed for further validation.In the future,we can learn from relevant foreign theoretical framework and development experience to develop decision-making aids that meet the needs of patients in China,so as to improve the decision-making quality of patients.
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