首页|决策辅助工具在癌症患者治疗决策中应用效果的系统评价再评价

决策辅助工具在癌症患者治疗决策中应用效果的系统评价再评价

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目的 系统评价再评价决策辅助工具(patient decision aids,PDAs)在癌症患者治疗决策中的应用效果.方法 计算机检索 PubMed、Web of Science、Cochrane Library、Embase、CINAHL、JBI、CNKI、VIP、CBM及WanFang Data数据库,搜集与研究目的相关的系统评价,检索时限均为建库至2023年9月.由2名研究者独立筛选文献、提取资料、评价纳入研究的方法学质量,进行证据的汇总与分级,并使用修正重叠区域(corrected covered area,CCA)调查所纳入系统评价中原始研究的重复情况.结果 共纳入17篇系统评价,其中13篇(76.47%)为低或极低质量研究;共包括64条证据,其中仅26条(40.62%)为中等质量.纳入研究所包含的原始研究为低度重叠(CCA=0.05).Meta分析结果显示,PDAs在癌症患者治疗决策中可增加决策相关知识、减少决策冲突及后悔(P<0.05),但对决策满意度、焦虑及抑郁无明显影响(P>0.05).结论 PDAs可提高癌症患者治疗决策相关知识水平、减少决策冲突及后悔,对决策准备度、决策满意度、焦虑及抑郁不会产生负面影响.但现有的系统评价证据质量较低,且局限于少数癌症类型.
Efficacy of patient decision aids in treatment decision-making for cancer patients:an overview of systematic reviews
Objective To overview the systematic reviews of the efficacy of cancer patient decision aids(PDAs)for treatment decision-making.Methods The PubMed,Web of Science,Cochrane Library,Embase,CINAHL,JBI,CNKI,VIP,CBM and WanFang Data databases were electronically searched to collect the systematic reviews relevant to the objective from inception to September 2023.Literature screening,data extraction,methodological quality assessment of the included literature,and summary and grading of the evidence were carried out independently by two researchers,and duplication of original studies in the included systematic evaluations was investigated using the corrected covered area(CCA).Results A total of 17 systematic reviews were included,of which 13(76.47%)were low-or very low-quality studies.A total of 64 pieces of evidence were included,of which only 26(40.62%)were of moderate quality,and the original studies included in the included literature had a low degree of overlap(CCA=0.05).The results of meta-analysis showed that PDAs could increase decision-related knowledge,reduce decision conflict and regret in cancer patients'treatment decision(P<0.05).However,there was no significant difference in decision satisfaction,anxiety or depression(P>0.05).Conclusion PDAs can improve cancer patients'knowledge related to treatment decision,reduce decision conflicts and regrets,and have no significant negative effects on decision preparation,satisfaction,anxiety,and depression.However,the existing systematic reviews are of low quality and limited to a few cancer types.

Cancer patientsPatient decision aidsTreatment decisionOverview of systematic reviews

盛婉婷、杨小惠、陈家欣、金蕾、朱慧敏、李祥云、赵林芳

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浙江大学医学院附属邵逸夫医院静脉治疗专科(杭州 310000)

癌症患者 患者决策辅助工具 治疗决策 系统评价再评价

浙江省医药卫生科技计划基金项目

2023KY803

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(6)