Gartlehner Gerald
Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Donau Universität Krems Österreich.
Z Evid Fortbild Qual Gesundhwes. 2011;105(3):176-82. doi: 10.1016/j.zefq.2011.03.004. Epub 2011 Mar 26.
The assessment of the balance between benefits and harms of population-based interventions faces both methodological and practical difficulties. This paper uses the example of cancer screening to outline existing challenges such as the consideration of outcomes that occur at substantially different times, or the lack of direct evidence which can lead to false conclusions and adverse health effects for healthy individuals undergoing screening. Sometimes not even sound evidence provides clear answers about the benefits and harms of preventive interventions. This is why informed decision-making is a particularly important step for individuals taking preventive interventions into consideration. Due to the lack of a clear answer to the question of benefits and harms from scientific evidence, individuals' attitudes and values may become a decisive factor. Studies, however, indicate that the prerequisite for informed decision making, namely objective and balanced information about benefits and harms, is often missing.
基于人群的干预措施利弊平衡评估面临方法学和实践方面的困难。本文以癌症筛查为例，概述了现有挑战，如考虑在截然不同时间发生的结果，或缺乏直接证据，这可能导致对接受筛查的健康个体得出错误结论并产生不良健康影响。有时，即使是可靠的证据也无法就预防性干预措施的利弊提供明确答案。这就是为什么明智决策对于考虑采取预防性干预措施的个人来说是特别重要的一步。由于科学证据未能明确回答利弊问题，个人的态度和价值观可能成为决定性因素。然而，研究表明，明智决策的先决条件，即关于利弊的客观和平衡信息，往往缺失。
