- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07590596
Preoperative Decision-Making in Patients With Pulmonary Nodules Suspected of Lung Cancer
Preoperative Decision-Making Characteristics and Associated Mechanisms in Patients With Pulmonary Nodules Suspected of Lung Cancer
Patients with pulmonary nodules that are highly suspected to be lung cancer often need to make important treatment decisions before a definite pathological diagnosis is available. These decisions may include whether to undergo surgery, whether to continue follow-up, whether to have further diagnostic tests, and how to understand the potential benefits and risks of different management options.
This prospective observational study aims to describe the preoperative decision-making status of adult patients with pulmonary nodules suspected of lung cancer. The study will assess patients' decision self-efficacy, decisional conflict, shared decision-making experience, and decision regret using standardized questionnaires. It will also explore factors associated with better or worse decision quality, such as demographic characteristics, clinical information, health literacy, doctor-patient communication, family involvement, and emotional status.
No treatment or intervention will be assigned by the study. Participants will receive routine clinical care, and study data will be collected mainly through questionnaires before surgery or during the preoperative period. The findings may help clinicians identify patients who need additional decision support and improve communication during preoperative decision-making for suspected lung cancer.
Přehled studie
Postavení
Intervence / Léčba
Detailní popis
Pulmonary nodules that are highly suspected of malignancy represent a common and clinically challenging scenario in thoracic surgery. Before a definite pathological diagnosis is available, patients may need to make complex decisions regarding surgery, additional diagnostic procedures, active surveillance, or other management strategies. These decisions are often made under uncertainty and may be influenced by patients' understanding of medical information, perceived cancer risk, fear of treatment delay, concerns about unnecessary surgery, family involvement, and communication with clinicians.
This is a single-center, prospective observational study conducted at Sichuan Cancer Hospital. The study plans to enroll approximately 200 adult patients with pulmonary nodules highly suspected of lung cancer who are facing preoperative clinical decision-making. The study will not assign any treatment, diagnostic procedure, or behavioral intervention. All clinical management decisions will be made according to routine clinical practice and shared discussion between patients and their treating clinicians.
The primary aim of the study is to characterize preoperative decision-making among patients with pulmonary nodules suspected of lung cancer. Specifically, the study will assess decision self-efficacy, decisional conflict, and decision quality. Decision self-efficacy will be evaluated using the Decision Self-Efficacy Scale. Decisional conflict will be assessed using the Decisional Conflict Scale. Decision quality and shared decision-making experience will be evaluated using instruments such as the SDM-Q-9 and decision regret-related measures, as applicable.
The study will also explore the relationships among decision self-efficacy, decisional conflict, and decision quality. Potential associated factors may include demographic characteristics, clinical characteristics, health literacy, quality of doctor-patient communication, family involvement, emotional status, and patient preferences. Data will be collected using structured questionnaires during the preoperative outpatient or inpatient period.
Descriptive statistics will be used to summarize participant characteristics and questionnaire scores. Correlation analyses, multivariable regression models, and, if appropriate, structural equation modeling will be used to examine the associations and potential pathways linking decision self-efficacy, decisional conflict, and decision quality. The study is expected to provide evidence for identifying patients at risk of poor decision quality and for developing future decision support strategies in thoracic surgical practice.
Typ studie
Zápis (Odhadovaný)
Kontakty a umístění
Studijní kontakt
- Jméno: Xing Wei, MD
- Telefonní číslo: +86 17302886627
- E-mail: xing.wei@scszlyy.org.cn
Studijní záloha kontaktů
- Jméno: Xing Wei
- Telefonní číslo: China
- E-mail: xing.wei@scszlyy.org.cn
Studijní místa
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Sichuan
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Chengdu, Sichuan, Čína, 610041
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China
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Kontakt:
- Xing Wei, MD
- Telefonní číslo: +86 17302886627
- E-mail: xing.wei@scszlyy.org.cn
-
Vrchní vyšetřovatel:
- Xing Wei, MD
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Metoda odběru vzorků
Studijní populace
Popis
Inclusion Criteria:
- Age 18 years or older.
- Adult patients with pulmonary nodules that are highly suspected of malignancy based on clinical and radiological assessment.
- No definite pathological diagnosis of lung cancer before enrollment.
- Patients who are facing preoperative clinical decision-making with more than one reasonable management option, such as surgery, additional diagnostic evaluation, or follow-up.
- Able to understand the study procedures and complete the study questionnaires.
- Able and willing to provide written informed consent.
Exclusion Criteria:
- Patients without a real clinical decision-making choice regarding the management of the pulmonary nodule.
- Patients with severe cognitive impairment or a history of severe psychiatric disease that would interfere with valid questionnaire completion.
- Patients who are unable to communicate effectively with the study staff.
- Patients who decline to participate or are unable to provide written informed consent.
Studijní plán
Jak je studie koncipována?
Detaily designu
Kohorty a intervence
Skupina / kohorta |
Intervence / Léčba |
|---|---|
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Patients With Pulmonary Nodules Suspected of Lung Cancer
Adult patients with pulmonary nodules highly suspected of lung cancer who are facing preoperative clinical decision-making before pathological confirmation.
Participants will receive routine clinical care.
No intervention, treatment assignment, or diagnostic procedure will be assigned by the study.
Study data will be collected using structured questionnaires to assess decision self-efficacy, decisional conflict, shared decision-making experience, decision regret, and related clinical and demographic factors.
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Participants will complete structured questionnaires during the preoperative outpatient or inpatient period.
The questionnaires will assess decision self-efficacy, decisional conflict, shared decision-making experience, decision regret, and related demographic and clinical factors.
The study will not assign any treatment, diagnostic procedure, surgery, or decision-support intervention.
All clinical care and management decisions will follow routine practice.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Decisional Conflict Scale Score
Časové okno: At enrollment during the preoperative period, before surgery
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Decisional conflict will be assessed using the Decisional Conflict Scale.
The scale evaluates uncertainty in decision-making, feeling uninformed, unclear personal values, inadequate support, and perceived ineffective decision-making.
The total score ranges from 0 to 100, with higher scores indicating greater decisional conflict.
A score of 37.5 or higher indicates clinically important decisional conflict.
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At enrollment during the preoperative period, before surgery
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Decision Self-Efficacy Scale Score
Časové okno: At enrollment during the preoperative period, before surgery
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Decision self-efficacy will be assessed using the Decision Self-Efficacy Scale.
The scale measures participants' confidence in obtaining information, understanding risks and benefits, clarifying personal values, expressing preferences, and making healthcare decisions.
The total score ranges from 0 to 100, with higher scores indicating greater decision self-efficacy.
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At enrollment during the preoperative period, before surgery
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Shared Decision-Making Questionnaire-9 Score
Časové okno: After preoperative clinical consultation and before surgery
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The shared decision-making experience will be assessed using the 9-item Shared Decision-Making Questionnaire.
The questionnaire evaluates the participant's perception of involvement in the clinical decision-making process.
The total score will be transformed to a 0-to-100 scale, with higher scores indicating a better shared decision-making experience.
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After preoperative clinical consultation and before surgery
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Decision Regret Scale Score
Časové okno: 1 month after the preoperative clinical decision
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Decision regret will be assessed using the Decision Regret Scale.
The scale measures distress or remorse after a healthcare decision has been made.
The total score ranges from 0 to 100, with higher scores indicating greater decision regret.
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1 month after the preoperative clinical decision
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Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Xing Wei, MD, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China
Publikace a užitečné odkazy
Obecné publikace
- Brehaut JC, O'Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, Feldman-Stewart D. Validation of a decision regret scale. Med Decis Making. 2003 Jul-Aug;23(4):281-92. doi: 10.1177/0272989X03256005.
- Kriston L, Scholl I, Holzel L, Simon D, Loh A, Harter M. The 9-item Shared Decision Making Questionnaire (SDM-Q-9). Development and psychometric properties in a primary care sample. Patient Educ Couns. 2010 Jul;80(1):94-9. doi: 10.1016/j.pec.2009.09.034. Epub 2009 Oct 30.
- O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995 Jan-Mar;15(1):25-30. doi: 10.1177/0272989X9501500105.
- Pompili C, Holch P, Rogers Z, Absolom K, Clayton B, Franks K, Bekker H, Velikova G. Patients' confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC). Health Qual Life Outcomes. 2020 Jul 18;18(1):237. doi: 10.1186/s12955-020-01496-9.
- Slatore CG, Wiener RS. Pulmonary Nodules: A Small Problem for Many, Severe Distress for Some, and How to Communicate About It. Chest. 2018 Apr;153(4):1004-1015. doi: 10.1016/j.chest.2017.10.013. Epub 2017 Oct 21.
- Freiman MR, Clark JA, Slatore CG, Gould MK, Woloshin S, Schwartz LM, Wiener RS. Patients' Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey. J Thorac Oncol. 2016 May;11(5):700-708. doi: 10.1016/j.jtho.2016.01.018. Epub 2016 Mar 7.
- Yuan J, Xu F, Sun Y, Ren H, Chen M, Feng S. Shared decision-making in the management of pulmonary nodules: a systematic review of quantitative and qualitative studies. BMJ Open. 2024 Jul 11;14(7):e079080. doi: 10.1136/bmjopen-2023-079080.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
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Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
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