Patients' intuitive judgments about surveillance endoscopy in Barrett's esophagus: a review and application to models of decision-making.

摘要: Summary Adherence to practice guidelines for endoscopic surveillance of Barrett's esophagus is equivocal with evidence underutilization and overutilization. While physicians report strong agreement adherence recommended endoscopy (esophagogastroduodenoscopy [EGD]) guidelines, less known about modifiable barriers facilitators shaping patients' behaviors. The aim this study conduct a structured literature review studies exploring perspectives regarding EGD place these results within conceptual framework. A PubMed, Cochrane, Google Scholar databases qualitative thematic analysis was performed. Six met eligibility criteria. Analysis identified five distinct themes. First, objective cancer risk estimates are consistent subjective perceptions, but neither associated surveillance. Second, patients have beliefs in the benefits screening trust their doctors. Third, anxiety depression symptoms related perceptions outcome expectancies Fourth, itself has affective physical consequences. Finally, health services system variables perception These themes coherently fit an integrated model intuitive decision-making Studies meeting criteria were heterogeneous terms objectives findings. Quantitative meta-analyses findings could not be To improve adherence, programs should consider how intuitively frame risks emotional reactions procedure, focus on communicate recommendations.