Med Decis Making - Patients' preferences and priorities regarding colorectal cancer screening.

Tópicos

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Resumo

CKGROUND: US colorectal cancer screening guidelines for people at average risk for colorectal cancer endorse multiple screening options and recommend that screening decisions reflect individual patient preferences.METHODS: The authors used the analytic hierarchy process (AHP) to ascertain decision priorities of people at average risk for colorectal cancer attending primary care practices in Rochester, New York; Birmingham, Alabama; and Indianapolis, Indiana. The analysis included 4 decision criteria, 3 subcriteria, and 10 options.RESULTS: Four hundred eighty-four people completed the study; 66% were female, 49% were African American, 9% had low literacy skills, and 27% had low numeracy skills. Overall, preventing cancer was given the highest priority (mean priority 55%), followed by avoiding screening test side effects (mean priority 17%), minimizing false-positive test results (mean priority 15%), and the combined priority of screening frequency, test preparation, and the test procedure(s) (mean priority 14%). Hierarchical cluster analysis revealed 6 distinct priority groupings containing multiple instances of decision priorities that differed from the average value by a factor of 4 or more. More than 90% of the study participants fully understood the concepts involved, 79% met AHP analysis quality standards, and 88% were willing to use similar methods to help make important health care decisions.CONCLUSION: These results highlight the need to facilitate incorporation of patient preferences into colorectal cancer screening decisions. The large number of study participants able and willing to perform the complex AHP analysis used for this study suggests that the AHP is a useful tool for identifying the patient-specific priorities needed to ensure that screening decisions appropriately reflect individual patient preferences.

Resumo Limpo

ckground us colorect cancer screen guidelin peopl averag risk colorect cancer endors multipl screen option recommend screen decis reflect individu patient preferencesmethod author use analyt hierarchi process ahp ascertain decis prioriti peopl averag risk colorect cancer attend primari care practic rochest new york birmingham alabama indianapoli indiana analysi includ decis criteria subcriteria optionsresult four hundr eightyfour peopl complet studi femal african american low literaci skill low numeraci skill overal prevent cancer given highest prioriti mean prioriti follow avoid screen test side effect mean prioriti minim falseposit test result mean prioriti combin prioriti screen frequenc test prepar test procedur mean prioriti hierarch cluster analysi reveal distinct prioriti group contain multipl instanc decis prioriti differ averag valu factor studi particip fulli understood concept involv met ahp analysi qualiti standard will use similar method help make import health care decisionsconclus result highlight need facilit incorpor patient prefer colorect cancer screen decis larg number studi particip abl will perform complex ahp analysi use studi suggest ahp use tool identifi patientspecif prioriti need ensur screen decis appropri reflect individu patient prefer

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