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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >The role of comorbidity assessment in guiding treatment decision-making for women with early breast cancer: a systematic literature review
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The role of comorbidity assessment in guiding treatment decision-making for women with early breast cancer: a systematic literature review

机译：合并症评估在早期乳腺癌妇女的指导治疗决策中的作用：系统文献综述

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Purpose Comorbidity in breast cancer patients impacts treatment choice, toxicity, and outcomes. While comorbidity measurement tools are frequently used by researchers, little is known about their use in clinical practice. The aim of this review was to examine the use of comorbidity measurement tools in clinical practice and their role in treatment decision-making in breast cancer. Methods Six electronic databases were searched from inception to 21 March 2019. Quantitative or mixed methods studies addressing primary treatment of breast cancer and identifying a comorbidity measurement tool used in clinical practice treatment decision-making were included. Data was extracted on tool utilized, impact on treatment decisions or outcomes, pattern of use, and psychometric properties. Results A systematic search of literature yielded 752 studies. Of the four studies that met inclusion criteria, each utilized a comprehensive geriatric assessment tool, though only in a subset of patients. No studies found direct comorbidity measurement tools utilized independently of geriatric assessment. Assessment results had variable impact on treatment decisions. Impacts on patient mortality and treatment toxicity, cost-effectiveness, and psychometric characteristics of the tools were not identified. Conclusions There is little evidence on use of specific comorbidity tools in clinical decision-making in breast cancer outside of comorbidity assessment as part of geriatric assessment tools. There was limited impact on decision-making or patient outcomes when these were utilized. Further research is needed to identify barriers to comorbidity assessment in clinical practice and identify comorbidity tools that have the potential to improve patient outcomes.
机译：乳腺癌患者的目的合并症会影响治疗选择，毒性和结果。虽然研究人员经常使用合并测量工具，但对于临床实践中的使用很少。本综述的目的是审查在临床实践中使用合并测量工具及其在乳腺癌中治疗决策中的作用。方法从2019年3月21日开始搜查六种电子数据库。包括患有乳腺癌初级治疗和鉴定用于临床实践治疗决策中使用的合并测量工具的定量或混合方法。数据在使用的工具上提取，影响治疗决策或结果，使用模式和心理测量性质。结果对文献进行了系统搜索，产生了752项研究。在符合纳入标准的四项研究中，每个研究都利用了一个综合的老年评估工具，但仅在患者的子集中。没有研究发现独立于老年评估使用的直接合并测量工具。评估结果对治疗决策产生了可变影响。没有确定对患者死亡率和治疗毒性，成本效益和锻炼的心理特征的影响。结论几乎没有关于在合并症评估外的乳腺癌外部临床决策中使用特定合并工具的证据，作为老年评估工具的一部分。在利用这些时，对决策或患者结果产生有限的影响。需要进一步研究以确定临床实践中的合并性评估的障碍，并鉴定具有改善患者结果的合并工具。

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