Developing a breast cancer screening decision aid in Spanish for average-risk women: a mixed methods study.

Introduction: We aimed to develop a decision aid to support shared-decision making between physicians and women with average breast cancer risk when deciding whether to participate in breast cancer screening. Methods: We included women at average risk of breast cancer and physicians involved in supporting the decision of breast cancer screening from an Academic Hospital in Buenos Aires, Argentina. We followed the International Patient Decision Aid Standards to develop our decision aid. Guided by a steering group and a multidisciplinary consultancy group including a patient advocate, we reviewed the evidence about breast cancer screening and previous decision aids, explored the patients' information needs on this topic from the patients' and physicians' perspective using semi-structured interviews, and we alpha-tested the prototype to determine its usability, comprehensibility and applicability. Results: We developed the first prototype of a web-based decision aid to use during the clinical encounter with women aged 40 to 69 with average breast cancer risk. After a meeting with our consultancy group, we developed a second prototype that underwent alpha-testing. Physicians and patients agreed that the tool was clear, useful and applicable during a clinical encounter. We refined our final prototype according to their feedback. Conclusion: We developed the first decision aid in our region and language on this topic, developed with end-users' input and informed by the best available evidence. We expect this decision aid to help women and physicians make shared decisions during the clinical encounter when talking about breast cancer screening.

Developing a breast cancer screening decision aid in Spanish for average-risk women: a mixed methods study / Estudios originales Publicado el 14 de marzo de 2024 | http://doi.org/10.5867/medwave.2024.02.2726 Developing a breast cancer screening decision aid in Spanish for average-risk women: a mixed methods study Desarrollo de una herramienta en español para ayudar en la toma de decisiones del cribado de cáncer de mama para mujeres de riesgo promedio: un estudio de métodos mixtos

Introduction We aimed to develop a decision aid to support shared-decision making between physicians and women with average breast cancer risk when deciding whether to participate in breast cancer screening. Methods We included women at average risk of breast cancer and physicians involved in supporting the decision of breast cancer screening from an Academic Hospital in Buenos Aires, Argentina. We followed the International Patient Decision Aid Standards to develop our decision aid. Guided by a steering group and a multidisciplinary consultancy group including a patient advocate, we reviewed the evidence about breast cancer screening and previous decision aids, explored the patients' information needs on this topic from the patients' and physicians' perspective using semi-structured interviews, and we alpha-tested the prototype to determine its usability, comprehensibility and applicability. Results We developed the first prototype of a web-based decision aid to use during the clinical encounter with women aged 40 to 69 with average breast cancer risk. After a meeting with our consultancy group, we developed a second prototype that underwent alpha-testing. Physicians and patients agreed that the tool was clear, useful and applicable during a clinical encounter. We refined our final prototype according to their feedback. Conclusion We developed the first decision aid in our region and language on this topic, developed with end-users' input and informed by the best available evidence. We expect this decision aid to help women and physicians make shared decisions during the clinical encounter when talking about breast cancer screening.

Implementación de una herramienta para toma de decisiones compartidas en tamizaje de cáncer de mama / Implementation of a tool for shared decision-making in breast cancer screening

INTRODUCCIÓN la Toma de Decisiones Compartidas (TDC) es un proceso mediante el cual el equipo de salud y el paciente trabajan juntos para tomar decisiones, basados en la mejor evidencia clínica y en las preferencias del paciente. en 2019 nuestro grupo de trabajo desarrolló una herramienta de ayuda para la toma de decisiones (hatd) para el tamizaje de cáncer de mama con mamografía. fue diseñada para usar durante la consulta médica, para mujeres de 40 a 69 años con riesgo promedio de cáncer de mama (http://decidirmamografia.com.ar/). OBJETIVOS evaluar la experiencia de uso de esta hatd, específicamente en la toma de decisiones informadas, tdc, conocimiento de beneficios y riesgos del tamizaje, conflicto decisional e intenciones de realizarse mamografía. RESULTADOS la media de edad fue de 56 años. Luego del uso de la herramienta, 12 de 27 pacientes (44%) lograron tomar una decisión informada, vs. una sola paciente (3%) que logró este objetivo antes del uso de la HATD, con una diferencia absoluta del 41% (I95%: 19 a 63, p=0.0010). Un 55% de las mujeres logró un conocimiento adecuado, vs un 7% antes del uso de la herramienta (DA 48%, IC 95%: 26 a 71; p=0.0002). Menos mujeres expresaron una actitud positiva hacia el tamizaje 37 vs 88% antes de la HATD (DA 51%; IC 95%: 74 a 29 p=0.0001); y menos mujeres tuvieron la intención de hacerse una mamografía (48 vs 74% antes de la HATD; DA: 26%; IC 95%: 0 a 52 p=0.0654). Sólo una paciente reportó un conflicto decisional alto, y el 80% de las pacientes consideró que había logrado la TDC. DISCUSIÓN la implementación de nuestra HATD demostró que un mayor número de mujeres logró tomar decisiones informadas, basadas en un adecuado conocimiento acerca de los beneficios y riesgos del tamizaje de cáncer de mama, y teniendo en cuenta sus propios valores y preferencias.

Erradicación de Helicobacter pylori en pacientes con dispepsia funcional / Helicobacter pylori eradication in patients with functional dyspepsia

La dispepsia constituye un motivo de consulta frecuente en atención primaria. A propósito de un paciente con diagnóstico de dispepsia funcional, la autora se plantea si el tratamiento de erradicación del Helicobacter pylori podría mejorar los síntomas. Luego de una búsqueda rápida se encontró evidencia que señala que el tratamiento de la infección por este germen podría ser beneficiosa para aliviar los síntomas de la dispepsia funcional a largo plazo, aunque con mayor riesgo de efectos adversos, por lo que otros tratamientos alternativos continúan siendo ser una opción válida en el manejo de los pacientes con este problema de salud. (AU)