McPherson K, Britton A
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1 7HT, UK.
Qual Health Care. 2001 Sep;10 Suppl 1(Suppl 1):i61-6. doi: 10.1136/qhc.0100061...
Preference for a particular intervention may, possibly via complicated pathways, itself confer an outcome advantage which will be subsumed in unblind randomised trials as part of the measured effectiveness of the intervention. Where more attractive interventions are compared with less attractive ones, any difference could therefore be a consequence of attractiveness and not its intrinsic worth. For health promotion interventions this is clearly important, but we cannot tell how important it is for therapeutic interventions without special studies to measure or refute such effects. These are difficult to do and are complex. Until the therapeutic effects of preference itself are more clearly understood, understanding the true therapeutic effects will be compromised, at least in principle.
对某种特定干预措施的偏好可能会通过复杂的途径本身赋予一种结果优势，而这在非盲法随机试验中会被纳入该干预措施所测量的有效性的一部分。当将更具吸引力的干预措施与吸引力较小的干预措施进行比较时，因此任何差异可能是吸引力的结果而非其内在价值。对于健康促进干预措施而言，这显然很重要，但如果没有专门的研究来测量或反驳这种影响，我们无法判断其对治疗性干预措施有多重要。这些研究很难进行且很复杂。在偏好本身的治疗效果得到更清楚的理解之前，对真正治疗效果的理解将受到损害，至少在原则上是这样。
