患者对美国放射学会前列腺 MRI PIRADS 评分中使用的标准化风险语言的看法。

IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of the American College of Radiology Pub Date : 2024-10-01 DOI:10.1016/j.jacr.2024.04.030
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引用次数: 0

摘要

导言:前列腺 MRI 报告使用标准化语言描述临床重大前列腺癌(csPCa)的风险,从 "不确定"(PI-RADS 3)、"可能"(PI-RADS 4)到 "高度可能"(PI-RADS 5)。根据 AUA 指南,这些术语分别对应 11%、37% 和 70% 的风险。我们评估了男性如何看待与标准化 PI-RADS 语言相关的风险:我们对符合美国前列腺癌人口统计学特征的 1204 名男性进行了众包调查。我们询问了参与者对标准化 PI-RADS 语言在不同语境下相关风险的感知:纯文字、PI-RADS-句子、完整报告和带数字估计的完整报告。报告了与 AUA 标准相比的感知风险中位数(IQR)和绝对低估/高估率。多变量线性混合效应分析确定了与风险认知准确性相关的因素:纯文字语境下的 csPCa 感知风险中位数(IQR)分别为 "模棱两可 "50%(50-74)、"很可能 "75%(68-85)和 "非常可能 "87%(78-92),高估率分别为 +39%、+38% 和 +17%。对于 PI-RADS 3、4 和 5,PI-RADS-句子上下文的感知风险中位数分别为 50%(50-50)、75%(68-81)和 90%(80-94),对应的高估率分别为 +39%、+38% 和 +20%。对于 PI-RADS 3、4 和 5,全面报告情况下的感知风险中位数分别为 50%(35-70)、72%(50-80)和 84%(54-91),高估率分别为 +39%、+35% 和 +14%。在描述 PI-RADS 4 病变的全面报告加数字估计的情况下,感知风险的中位数为 70%(50-80),相当于高估了 +33%。包括数字估计在内的正确风险认知从 3% 增加到 11%(p 结论:男性高估了冠状动脉栓塞的风险:无论在何种情况下,男性都会高估与标准化 PI-RADS 语言相关的 csPCa 风险,尤其是对于 PI-RADS 3 和 4 病变。应考虑修改 PI-RADS 语言或成像报告的数据共享政策。
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Patient Perceptions of Standardized Risk Language Used in ACR Prostate MRI PI-RADS Scores

Introduction

Prostate MRI reports use standardized language to describe risk of clinically significant prostate cancer (csPCa) from “equivocal” (Prostate Imaging Reporting and Data System [PI-RADS] 3), “likely” (PI-RADS 4), to “highly likely” (PI-RADS 5). These terms correspond to risks of 11%, 37%, and 70% according to American Urological Association guidelines, respectively. We assessed how men perceive risk associated with standardized PI-RADS language.

Methodology

We conducted a crowdsourced survey of 1,204 men matching a US prostate cancer demographic. We queried participants’ risk perception associated with standardized PI-RADS language across increasing contexts: words only, PI-RADS sentence, full report, and full report with numeric estimate. Median perceived risk (interquartile range) and absolute under/overestimation compared with American Urological Association standards were reported. Multivariable linear mixed-effects analysis identified factors associated with accuracy of risk perception.

Results

Median perceived risks of csPCa (interquartile range) for the word-only context were “equivocal” 50% (50%-74%), “likely” 75% (68%-85%), and “highly likely” 87% (78%-92%), corresponding to +39%, +38%, and +17% overestimation, respectively. Median perceived risks for the PI-RADS-sentence context were 50% (50%-50%), 75% (68%-81%), and 90% (80%-94%) for PI-RADS 3, 4, and 5, corresponding to +39%, +38%, and +20% overestimation, respectively. Median perceived risks for the full-report context were 50% (35%-70%), 72% (50%-80%), and 84% (54%-91%) for PI-RADS 3, 4, and 5, corresponding to +39%, +35%, and +14% overestimation, respectively. For the full-report-with-numeric-estimate context describing a PI-RADS 4 lesion, median perceived risk was 70% (50%-%80), corresponding to +33% overestimation. Including numeric estimates increased correct perception of risk from 3% to 11% (P < .001), driven by men with higher numeracy (odds ratio 1.24, P = .04).

Conclusion

Men overestimate risk of csPCa associated with standardized PI-RADS language regardless of context, especially for PI-RADS 3 and 4 lesions. Changes to PI-RADS language or data-sharing policies for imaging reports should be considered.
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来源期刊
Journal of the American College of Radiology
Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
6.30
自引率
8.90%
发文量
312
审稿时长
34 days
期刊介绍: The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.
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