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The development and comparative effectiveness of a patient-centered prostate biopsy report: a prospective, randomized study.
Prostate Cancer and Prostatic Diseases ( IF 5.1 ) Pub Date : 2019-08-28 , DOI: 10.1038/s41391-019-0169-7 Jasmir G Nayak 1 , Nicholas Scalzo 2 , Alice Chu 2 , Benjamin Shiff 1 , James T Kearns 2 , Geolani W Dy 3 , Liam C Macleod 4 , Matthew Mossanen 5 , William J Ellis 2 , Daniel W Lin 2 , Jonathan L Wright 2 , Lawrence D True 6 , John L Gore 2
Prostate Cancer and Prostatic Diseases ( IF 5.1 ) Pub Date : 2019-08-28 , DOI: 10.1038/s41391-019-0169-7 Jasmir G Nayak 1 , Nicholas Scalzo 2 , Alice Chu 2 , Benjamin Shiff 1 , James T Kearns 2 , Geolani W Dy 3 , Liam C Macleod 4 , Matthew Mossanen 5 , William J Ellis 2 , Daniel W Lin 2 , Jonathan L Wright 2 , Lawrence D True 6 , John L Gore 2
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PURPOSE
The prostate biopsy pathology report represents a critical document used for decision-making in patients diagnosed with prostate cancer, yet the content exceeds the health literacy of most patients. We sought to create and compare the effectiveness of a patient-centered prostate biopsy report compared with standard reports.
MATERIALS AND METHODS
Using a modified Delphi approach, prostate cancer experts identified critical components of a prostate biopsy report. Patient focus groups provided input for syntax and formatting of patient-centered pathology reports. Ninety-four patients with recent prostate biopsies were block randomized to the standard report with or without the patient-centered report. We evaluated patient activation, self-efficacy, provider communication skills, and prostate cancer knowledge.
RESULTS
Experts selected primary and secondary Gleason score and the number of positive scores as the most important elements of the report. Patients prioritized a narrative design, non-threatening language and information on risk classification. Initial assessments were completed by 87% (40/46) in the standard report group and 81% (39/48) in the patient-centered report group. There were no differences in patient activation, self-efficacy, or provider communication skills between groups. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.026) and number of positive cores (90% vs. 65%, p = 0.014). In total, 86% of patients who received the patient-centered report felt that it helped them better understand their results and should always be provided.
CONCLUSIONS
Patient-centered pathology reports are associated with significantly higher knowledge about a prostate cancer diagnosis. These important health information documents may improve patient-provider communication and help facilitate shared decision-making among patients diagnosed with prostate cancer.
中文翻译：
以患者为中心的前列腺活检报告的制定和比较有效性：一项前瞻性随机研究。
目的前列腺活检病理报告是前列腺癌患者决策的重要文件，但其内容超出了大多数患者的健康素养。我们试图创建并比较以患者为中心的前列腺活检报告与标准报告的有效性。材料和方法 前列腺癌专家使用改良的德尔菲法确定了前列腺活检报告的关键组成部分。患者焦点小组为以患者为中心的病理报告的语法和格式提供了输入。 94 名最近接受过前列腺活检的患者被随机分组接受标准报告，无论是否有以患者为中心的报告。我们评估了患者的积极性、自我效能、提供者的沟通技巧和前列腺癌知识。结果 专家们选择小学和中学格里森评分以及阳性评分的数量作为报告中最重要的要素。患者优先考虑叙事设计、非威胁性语言和风险分类信息。标准报告组的初始评估完成率为 87% (40/46)，以患者为中心的报告组的初始评估完成率为 81% (39/48)。各组之间的患者积极性、自我效能或提供者沟通技巧没有差异。收到以患者为中心的报告的患者回忆格里森评分的能力（100% vs. 85%，p = 0.026）和阳性核心数量（90% vs. 65%，p = 0.014）显着提高。总的来说，86% 收到以患者为中心的报告的患者认为这有助于他们更好地了解自己的结果，因此应该始终提供。 结论 以患者为中心的病理报告与前列腺癌诊断知识的显着提高相关。这些重要的健康信息文件可以改善患者与提供者之间的沟通，并有助于促进诊断为前列腺癌的患者之间的共同决策。
更新日期：2019-08-28
中文翻译：
以患者为中心的前列腺活检报告的制定和比较有效性：一项前瞻性随机研究。
目的前列腺活检病理报告是前列腺癌患者决策的重要文件，但其内容超出了大多数患者的健康素养。我们试图创建并比较以患者为中心的前列腺活检报告与标准报告的有效性。材料和方法 前列腺癌专家使用改良的德尔菲法确定了前列腺活检报告的关键组成部分。患者焦点小组为以患者为中心的病理报告的语法和格式提供了输入。 94 名最近接受过前列腺活检的患者被随机分组接受标准报告，无论是否有以患者为中心的报告。我们评估了患者的积极性、自我效能、提供者的沟通技巧和前列腺癌知识。结果 专家们选择小学和中学格里森评分以及阳性评分的数量作为报告中最重要的要素。患者优先考虑叙事设计、非威胁性语言和风险分类信息。标准报告组的初始评估完成率为 87% (40/46)，以患者为中心的报告组的初始评估完成率为 81% (39/48)。各组之间的患者积极性、自我效能或提供者沟通技巧没有差异。收到以患者为中心的报告的患者回忆格里森评分的能力（100% vs. 85%，p = 0.026）和阳性核心数量（90% vs. 65%，p = 0.014）显着提高。总的来说，86% 收到以患者为中心的报告的患者认为这有助于他们更好地了解自己的结果，因此应该始终提供。 结论 以患者为中心的病理报告与前列腺癌诊断知识的显着提高相关。这些重要的健康信息文件可以改善患者与提供者之间的沟通，并有助于促进诊断为前列腺癌的患者之间的共同决策。
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