Frequency format diagram and probability chart for breast cancer risk communication: a prospective, randomized trial.

BACKGROUND: Breast cancer risk education enables women make informed decisions regarding their options for screening and risk reduction. We aimed to determine whether patient education regarding breast cancer risk using a bar graph, with or without a frequency format diagram, improved the accuracy of risk perception. METHODS: We conducted a prospective, randomized trial among women at increased risk for breast cancer. The main outcome measurement was patients' estimation of their breast cancer risk before and after education with a bar graph (BG group) or bar graph plus a frequency format diagram (BG+FF group), which was assessed by previsit and postvisit questionnaires. RESULTS: Of 150 women in the study, 74 were assigned to the BG group and 76 to the BG+FF group. Overall, 72% of women overestimated their risk of breast cancer. The improvement in accuracy of risk perception from the previsit to the postvisit questionnaire (BG group, 19% to 61%; BG+FF group, 13% to 67%) was not significantly different between the 2 groups (P = .10). Among women who inaccurately perceived very high risk (> or = 50% risk), inaccurate risk perception decreased significantly in the BG+FF group (22% to 3%) compared with the BG group (28% to 19%) (P = .004). CONCLUSION: Breast cancer risk communication using a bar graph plus a frequency format diagram can improve the short-term accuracy of risk perception among women perceiving inaccurately high risk.

Diabetes mellitus in pancreatic cancer patients in the Czech Republic: sex differences.

AIMS: The prevalence of diabetes mellitus in pancreatic cancer patients and control subjects was compared. METHODS: Retrospective evaluation of 182 pancreatic cancer patients and 135 controls. The presence of diabetes was evaluated and the time period between the diagnosis of diabetes and pancreatic cancer was assessed. A subanalysis based on patient sex was conducted. RESULTS: Diabetes mellitus was present in 64 patients (35.2%) in pancreatic cancer group and in 27 patients (20.0%) in control group (χ(2) = 8.709; P = 0.003). In 18 patients (28.1% of diabetic pancreatic cancer patients) diabetes was new-onset. Diabetes was new-onset in 23.3% of females compared to 38.1% of males (χ(2) = 1.537; P = 0.215). The overall prevalence of diabetes was significantly higher among female pancreatic cancer patients (25% versus 43.9%; χ(2) = 7.070, P = 0.008), while diabetes prevalence was equally represented in the control group patients (22.1% versus 17.2%; χ(2) = 0.484, P = 0.487). CONCLUSION: The prevalence of diabetes mellitus in study group of pancreatic cancer patients was significantly higher when compared to control group. Pancreatic cancer patients with diabetes were predominantly females, while diabetes was equally prevalent among sexes in the control group. Therefore, patient sex may play important role in the risk stratification.

Anxiety levels, fear-avoidance beliefs, and disability levels at baseline and at 1 year among subjects with acute and chronic low back pain.

OBJECTIVE: To compare anxiety levels, fear-avoidance beliefs, and disability levels over 1 year for patients with acute (< or =3 months) and chronic (>3 months) low back pain (LBP). DESIGN: Prospective study with questionnaire measurements. SETTING: Tertiary care clinic. PATIENTS: Patients with acute or chronic LBP who resided in a 3-county local area and presented to our clinic for initial evaluation. METHODS: Administration of and results analysis from Fear-Avoidance Beliefs Questionnaire, Oswestry Disability Index, Pain and Impairment Relationship Scale, and Spielberger State-Trait Anxiety Inventory at baseline and 12 months. Trait anxiety was measured at baseline only. MAIN OUTCOME MEASUREMENTS: Scores from questionnaires assessing fear-avoidance beliefs and state and trait anxiety, as well as LBP disability levels. RESULTS: In total, 138 patients with acute LBP and 107 with chronic LBP were enrolled. Of these patients, 111 with acute and 86 with chronic LBP completed the study. The 2 groups were statistically indistinguishable at baseline on all measures except trait anxiety scores, which were significantly higher in the group with chronic LBP than in the acute group (P = .01). At 1 year, the acute group had a statistically significant improvement in all outcome measures except state anxiety. The group with chronic LBP had significant improvement in all measures except fear-avoidance beliefs and state anxiety. Overall, the group with acute LBP improved more in all measurement instruments than the chronic LBP group (a statistically significant difference) except state anxiety. CONCLUSIONS: The group with chronic LBP exhibited a higher level of trait anxiety at baseline than those with acute LBP and, unlike the acute LBP group, did not have improved fear-avoidance beliefs over 1 year. The relationship between anxiety and chronic LBP is novel. Because anxiety is potentially modifiable, future studies that evaluate the relationship between LBP and anxiety are warranted.