Kattan Michael W
Departments of Urology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Oncology (Williston Park). 2003 Dec;17(12):1687-93; discussion 1693-4, 1697, 1701.
When comparing treatments, the simple question of which treatment produces a better outcome prompts a complicated answer if both quantity and quality of life are considered. This is particularly evident when the treatment associated with better survival worsens quality of life, at least for part of the time, or when certain aspects of quality of life are better with one treatment while other aspects are better with another treatment. Utility assessment is an evolving discipline that offers an attractive conceptual solution to these problems. The popular approaches are described, and one particular method, the standard gamble, is advocated. Utility is easily measured by the standard gamble, and it has good psychometric and theoretical properties.
在比较不同治疗方法时，如果同时考虑生活质量和数量，那么哪种治疗方法能产生更好的结果这个简单的问题会引出一个复杂的答案。当与更好的生存率相关的治疗方法会降低生活质量（至少在部分时间如此），或者当一种治疗方法在生活质量的某些方面更好而另一种治疗方法在其他方面更好时，这一点尤其明显。效用评估是一门不断发展的学科，它为这些问题提供了一个有吸引力的概念性解决方案。本文描述了常用的方法，并倡导一种特定的方法——标准博弈法。效用很容易通过标准博弈法来衡量，并且它具有良好的心理测量学和理论特性。
