基于互联网的决策辅助工具在结直肠癌筛查中应用效果的系统评价

The effectiveness of internet-based decision aids in colorectal cancer screening:A systematic review

目的 系统评价基于互联网的决策辅助工具(decision aids,DA)在结直肠癌筛查中的应用效果。方法 计算机检索中国知网、万方数据、重庆维普、中国生物医学文献数据库、PubMed、the Cochrane Library、Embase、Web of Science中有关基于互联网的DA在结直肠癌筛查中应用效果的随机对照试验,检索时间从建库至2023年6月。采用描述性分析法分析DA研发的主要内容,总结其临床应用效果。结果 共纳入12篇文献,包括6038例研究对象,其中实验组3089例,对照组2949例。研究结果显示基于互联网的DA内容主要包括基本信息支持、结直肠癌筛查益处及风险、患者个人价值观澄清;其可帮助患者增强筛查意愿、提升知情决策能力,减少决策冲突,并促进患者在决策中的积极作用;患者对基于互联网的DA满意度较高。结论 基于互联网的DA在结直肠癌筛查应用中展示出积极效果,较传统纸质版手册有其独特的优势,但仍具有一定局限性。未来可借鉴国外决策辅助相关理论成果,结合中国国情研发和构建更加全面的结直肠癌筛查的DA。

Objective To evaluate the effectiveness of internet-based decision aids(DA) in colorectal cancer screening.Methods Randomized controlled trials of efficacy of internet-based DA in colorectal cancer screening were searched by computer from CNKI,Wanfang Data,VIP,CBM,PubMed,the Cochrane Library,Embase and Web of Science.The retrieval period was from the establishment of the database to June 2023.Descriptive analysis was used to analyze the main contents and summarize their clinical application effects.Results A total of 12 literatures were included,including 6038 subjects,of which 3089 were in experimental group and 2949 were in control group.The results showed that the contents of internet-based DA mainly included basic information support,benefits and risks of colorectal cancer screening,and clarification of patients' personal values.It could help patients enhance screening willingness,improve informed decision-making ability,reduce decision-making conflicts,and promote the positive role of patients in decision-making.Patients have higher satisfaction with internet-based DA.Conclusion Internet-based DA has shown positive results in the application of colorectal cancer screening,and has unique advantages over the traditional paper version of the manual,but it still has certain limitations.In the future,we can learn from the relevant theoretical achievements of foreign decision-making assistance,research and develop a more comprehensive DA for colorectal cancer screening combined with China's national conditions.