Abstract:

Objective　To systematically evaluate the application effect of web-based decision aids (DA) in prostatic cancer treatment decisions. Methods　Randomized controlled trials on the application effect of web-based DA in prostatic cancer treatment decisions were retrieved from databases such as CNKI, Wanfang, VIP, PubMed, the Cochrane Library, Embase, and Web of Science from the establishment of the databases to August 7, 2024, and the references included in the studies were traced. Subject words combined with free words were used to search. Meta-analysis was performed using RevMan 5.3 software, and publication bias was assessed by funnel plot. Results　Finally, 13 articles were included. The results of the meta-analysis showed that the proportion of the patients who chose conservative treatment in the intervention group was higher than that in the conventional group [RR=1.19, 95%CI:(1.02, 1.39), P=0.03]; the impact of web-based DA on the choice of radical prostatectomy [RR=1.01, 95%CI:(0.92, 1.10), P=0.87] and radiotherapy [RR=0.84, 95%CI:(0.62, 1.15), P=0.28] in patients with localized prostate cancer had no statistical significance; for patients with low-risk prostate cancer, the difference in the choice of radical prostatectomy [RR=0.73, 95%CI:(0.54, 0.98), P=0.04] was statistically significant; there were no statistically significant differences between the intervention group and the conventional group in terms of decision conflict [SMD=-0.03, 95%CI:(-0.11, 0.05), P=0.42], decision regret [SMD=0.01, 95%CI:(-0.24, 0.26), P=0.94], or satisfaction [SMD=-0.11, 95%CI:(-0.44, 0.22), P=0.50]. Conclusion　DA has a certain intervention effect on the treatment decisions in patients with prostate cancer.

Key words:

Decision aids, Prostate cancer, Network, Meta-analysis, Treatment  , decision

摘要：

目的　系统评价基于网络的决策辅助工具（DA）在前列腺癌治疗决策中的应用效果。方法　计算机检索PubMed、Embase、Web of Science、The Cochrane Library、CINAHL、MEDLINE、中国知网（CNKI）、万方数据库和维普数据库中建库至2024年8月7日有关基于网络的DA在前列腺癌治疗决策中应用效果的随机对照试验，并追溯纳入研究的参考文献。采用主题词结合自由词方式检索。采用RevMan 5.3软件进行meta分析，采用漏斗图评估发表偏倚。结果　共纳入13篇文献。Meta分析结果显示：干预组选择保守治疗比例高于对照组，差异有统计学意义［RR=1.19，95%CI：（1.02，1.39），P=0.03］；干预组与对照组选择前列腺癌根治术和放疗比例比较，差异均无统计学意义［RR=1.01，95%CI：（0.92，1.10），P=0.87；RR=0.84，95%CI：（0.62，1.15），P=0.28］；在低危患者中，干预组选择前列腺癌根治术的比例低于对照组［RR=0.73，95%CI：（0.54，0.98），P=0.04］；干预组与对照组决策冲突和决策后悔比例比较，差异无统计学意义［SMD=-0.03，95%CI：（-0.11，0.05），P=0.42；SMD=0.01，95%CI：（-0.24，0.26），P=0.94］；干预组与对照组满意度比较，差异无统计学意义［SMD=-0.11，95%CI：（-0.44，0.22），P=0.50］。结论　DA具有影响前列腺癌患者治疗决策的潜力。

关键词:

决策辅助工具, 前列腺癌, 网络, Meta分析, 治疗决策