Pecchia L, Bath P A, Pendleton N, Bracale M
Department of Biomedical, Electronic and Telecommunication Engineering, University Federico II of Naples, Via Claudio 21, 80125 Naples, Italy.
Methods Inf Med. 2011;50(5):435-44. doi: 10.3414/ME10-01-0028. Epub 2010 Dec 6.
A gap exists between evidence-based medicine and clinical-practice. Every day, healthcare professionals (HCPs) combine empirical evidence and subjective experience in order to maximize the effectiveness of interventions. Consequently, it is important to understand how HCPs interpret the research evidence and apply it in everyday practice. We focused on the prevention of falls, a common cause of injury-related morbidity and mortality in later life, for which there is a wide range of known risk factors.
To use the Analytic Hierarchy Process (AHP) to investigate the opinions of HCPs in prioritizing risk factors for preventing falls.
We used the AHP to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts. We submitted electronic questionnaires via the web, in order to reach a wider number of respondents. With a web service, we pooled the results and weighted the coherence and the experience of respondents.
Overall, 232 respondents participated in the study: 32 in the technical pilot study, nine in the scientific pilot study and 191 respondents in the main study. We identified a hierarchy of 35 risk factors, organized in two categories and six sub-categories.
The hierarchy of risk factors provides further insights into clinicians' perceptions of risk factors for falls. This hierarchy helps understand the relative importance that clinicians place on risk factors for falls in older people and why evidence-based guidelines are not always followed. This information may be helpful in improving intervention programs and in understanding how clinicians prioritize multiple risk factors in individual patients. The AHP method allows the opinions of HCPs to be investigated, giving appropriate weight to their coherence, background and experience.
循证医学与临床实践之间存在差距。医疗保健专业人员（HCPs）每天都会将实证证据和主观经验结合起来，以最大限度地提高干预措施的有效性。因此，了解HCPs如何解读研究证据并将其应用于日常实践非常重要。我们关注跌倒的预防，跌倒是晚年与伤害相关的发病和死亡的常见原因，已知有多种风险因素。
使用层次分析法（AHP）调查HCPs在确定跌倒预防风险因素优先级方面的意见。
我们基于专家的知识和经验，使用AHP建立了跌倒风险因素层次结构。我们通过网络提交电子问卷，以覆盖更多的受访者。通过网络服务，我们汇总了结果，并对受访者的一致性和经验进行了加权。
总体而言，232名受访者参与了该研究：技术预试验中有32人，科学预试验中有9人，主要研究中有191名受访者。我们确定了一个由35个风险因素组成的层次结构，分为两类和六个子类别。
风险因素层次结构为临床医生对跌倒风险因素的认知提供了进一步的见解。该层次结构有助于理解临床医生对老年人跌倒风险因素的相对重视程度，以及为什么循证指南并非总是得到遵循。这些信息可能有助于改进干预计划，并有助于理解临床医生如何在个体患者中对多个风险因素进行优先级排序。层次分析法允许对HCPs的意见进行调查，同时适当考虑他们的一致性、背景和经验。
