PDF(Pubmed)
Abstract：
BACKGROUND: Novel, less-invasive technologies to screen for Barrett\'s esophagus (BE) may enable a paradigm shift in early detection strategies for esophageal adenocarcinoma (EAC). Understanding professionals\' perspectives on screening is important to determine how to proceed. We aimed to explore and compare professionals\' perceptions of screening for BE and EAC screening in three countries.
METHODS: In this study, 29 Dutch, 20 British and 18 American health care professionals (clinicians, researchers and policy makers) participated in concept mapping: a mixed-methods consensus building methodology. Statements on perceived barriers, facilitators, advantages, disadvantages, implications or worries associated with screening for BE and EAC were collected in asynchronous digital brainstorm sessions. Subsequently, participants sorted the statements into groups according to thematic similarity and assessed the relevance of each statement in evaluating the acceptability of BE and EAC screening. Multidimensional scaling and cluster analysis were used to map the associations between generated statements.
RESULTS: Professionals across three countries identified eight consistent themes that relate to their perceptions of screening for BE and EAC: (1) Benefits, (2) Harms, (3) Clinical effectiveness concerns, (4) Screening population, (5) Screening modality, (6) Resources, (7) Ownership, and (8) Public communication. Dutch and American professionals prioritized the potential health benefits of screening but also questioned clinical impact. In contrast, British participants prioritized identification of the screening population and suitable test.
CONCLUSIONS: Most professionals see potential in less-invasive screening tests for BE and EAC but underline the need to define the target screening population and determine benefits and harms before widely employing them. Successful implementation will require thoughtful consideration of the involvement of general practitioners, readiness of endoscopy and pathology services, balanced public communication, and country-specific regulations.
METHODS: In this study, 29 Dutch, 20 British and 18 American health care professionals (clinicians, researchers and policy makers) participated in concept mapping: a mixed-methods consensus building methodology. Statements on perceived barriers, facilitators, advantages, disadvantages, implications or worries associated with screening for BE and EAC were collected in asynchronous digital brainstorm sessions. Subsequently, participants sorted the statements into groups according to thematic similarity and assessed the relevance of each statement in evaluating the acceptability of BE and EAC screening. Multidimensional scaling and cluster analysis were used to map the associations between generated statements.
RESULTS: Professionals across three countries identified eight consistent themes that relate to their perceptions of screening for BE and EAC: (1) Benefits, (2) Harms, (3) Clinical effectiveness concerns, (4) Screening population, (5) Screening modality, (6) Resources, (7) Ownership, and (8) Public communication. Dutch and American professionals prioritized the potential health benefits of screening but also questioned clinical impact. In contrast, British participants prioritized identification of the screening population and suitable test.
CONCLUSIONS: Most professionals see potential in less-invasive screening tests for BE and EAC but underline the need to define the target screening population and determine benefits and harms before widely employing them. Successful implementation will require thoughtful consideration of the involvement of general practitioners, readiness of endoscopy and pathology services, balanced public communication, and country-specific regulations.
摘要：
背景：小说，筛查Barrett食管(BE)的侵入性较小的技术可能使食管腺癌(EAC)早期检测策略的范式转变。了解专业人员对筛查的看法对于确定如何进行是很重要的。我们旨在探索和比较三个国家的专业人员对BE和EAC筛查的看法。
方法：在本研究中，29荷兰人，20名英国人和18名美国医疗保健专业人员(临床医生，研究人员和政策制定者)参与了概念图：一种混合方法共识构建方法。关于感知障碍的声明，主持人，优势,缺点,在异步数字头脑风暴会议中收集了与BE和EAC筛查相关的影响或担忧。随后，参与者根据主题相似性将陈述分组,并评估每个陈述在评估BE和EAC筛查可接受性方面的相关性.使用多维缩放和聚类分析来映射生成的语句之间的关联。
结果：三个国家的专业人员确定了八个一致的主题，这些主题与他们对BE和EAC筛查的看法有关：（1）益处，(2)危害,（3）临床有效性问题，（4）筛查人群，(5)筛选方式，（6）资源，(7)所有权,（8）公共沟通。荷兰和美国的专业人士优先考虑筛查的潜在健康益处，但也质疑临床影响。相比之下,英国参与者优先识别筛查人群和合适的测试。
结论：大多数专业人员认为BE和EAC的侵入性较小的筛查测试具有潜力，但强调需要确定目标筛查人群，并在广泛使用它们之前确定益处和危害。成功实施将需要对全科医生的参与进行深思熟虑的考虑，内窥镜检查和病理服务的准备，平衡的公共沟通，和特定国家的法规。
方法：在本研究中，29荷兰人，20名英国人和18名美国医疗保健专业人员(临床医生，研究人员和政策制定者)参与了概念图：一种混合方法共识构建方法。关于感知障碍的声明，主持人，优势,缺点,在异步数字头脑风暴会议中收集了与BE和EAC筛查相关的影响或担忧。随后，参与者根据主题相似性将陈述分组,并评估每个陈述在评估BE和EAC筛查可接受性方面的相关性.使用多维缩放和聚类分析来映射生成的语句之间的关联。
结果：三个国家的专业人员确定了八个一致的主题，这些主题与他们对BE和EAC筛查的看法有关：（1）益处，(2)危害,（3）临床有效性问题，（4）筛查人群，(5)筛选方式，（6）资源，(7)所有权,（8）公共沟通。荷兰和美国的专业人士优先考虑筛查的潜在健康益处，但也质疑临床影响。相比之下,英国参与者优先识别筛查人群和合适的测试。
结论：大多数专业人员认为BE和EAC的侵入性较小的筛查测试具有潜力，但强调需要确定目标筛查人群，并在广泛使用它们之前确定益处和危害。成功实施将需要对全科医生的参与进行深思熟虑的考虑，内窥镜检查和病理服务的准备，平衡的公共沟通，和特定国家的法规。
