Dahl Rasmus, Gyrd-Hansen Dorte, Kristiansen Ivar Sønbø, Nexøe Jørgen, Bo Nielsen Jesper
Research Unit of General Practice, University of Southern Denmark Odense, Denmark.
BMC Med Inform Decis Mak. 2007 Mar 29;7:8. doi: 10.1186/1472-6947-7-8.
For shared decision making doctors need to communicate the effectiveness of therapies such that patients can understand it and discriminate between small and large effects. Previous research indicates that patients have difficulties in understanding risk measures. This study aimed to test the hypothesis that lay people may be able to discriminate between therapies when their effectiveness is expressed in terms of postponement of an adverse disease event.
In 2004 a random sample of 1,367 non-institutionalized Danes aged 40+ was interviewed in person. The participants were asked for demographic information and asked to consider a hypothetical preventive drug treatment. The respondents were randomized to the magnitude of treatment effectiveness (heart attack postponement of 1 month, 6 months, 12 months, 2 years, 4 years and 8 years) and subsequently asked whether they would take such a therapy. They were also asked whether they had hypercholesterolemia or had experienced a heart attack.
In total 58% of the respondents consented to the hypothetical treatment. The proportions accepting treatment were 39%, 52%, 56%, 64%, 67% and 73% when postponement was 1 month, 6 months, 12 months, 2 years, 4 years and 8 years respectively. Participants who thought that the effectiveness information was difficult to understand, were less likely to consent to therapy (p = 0.004).
Lay people can discriminate between levels of treatment effectiveness when they are presented in terms of postponement of an adverse event. The results indicate that such postponement is a comprehensible measure of effectiveness.
为了进行共同决策，医生需要传达治疗方法的有效性，以便患者能够理解并区分效果的大小。先前的研究表明，患者在理解风险度量方面存在困难。本研究旨在检验这样一个假设：当用不良疾病事件的推迟来表示治疗效果时，非专业人士可能能够区分不同的治疗方法。
2004年，对1367名年龄在40岁及以上的非机构化丹麦人进行了随机抽样的面对面访谈。询问了参与者的人口统计学信息，并要求他们考虑一种假设的预防性药物治疗。受访者被随机分配到不同的治疗效果程度（心脏病发作推迟1个月、6个月、12个月、2年、4年和8年），随后被问及是否会接受这种治疗。还询问了他们是否患有高胆固醇血症或曾经历过心脏病发作。
总共有58%的受访者同意接受这种假设的治疗。当推迟时间分别为1个月、6个月、12个月、2年、4年和8年时，接受治疗的比例分别为39%、52%、56%、64%、67%和73%。认为效果信息难以理解的参与者同意接受治疗的可能性较小（p = 0.004）。
当用不良事件的推迟来表示治疗效果水平时，非专业人士能够区分不同的治疗效果水平。结果表明，这种推迟是一种易于理解的效果度量方法。
