Kubu C S, Ford P J
Cleveland Clinic.
AJOB Neurosci. 2012 Jan;3(1):44-49. doi: 10.1080/21507740.2011.633960. Epub 2012 Jan 5.
Assessment of outcome following Deep Brain Stimulation (DBS) has traditionally focused on symptom specific and quality of life measures. Greater attention needs to be paid to the diversity of patient goals and values, as well as recognition of the shifting nature of those goals over the course of DBS therapy. We report preliminary data from an empirical study examining patients' goals with respect to DBS in the treatment of Parkinson disease. We argue that a multifaceted assessment of outcome over time, including well validated symptom measures, quality of life, functional and patient specific metrics, is ethically necessary in order to fulfill fiduciary and professional responsibilities. These assessments should be augmented with a deliberative multi-disciplinary process of review and evaluation. Such an approach will lead to improved inform consent, promote better clinical research, and facilitate good patient care by providing a systematic mechanism for capturing and acting on important patient insights. These processes become increasingly critical as DBS begins to be applied to neuropsychiatric disorders.
传统上，对脑深部电刺激（DBS）治疗效果的评估主要集中在特定症状和生活质量指标上。需要更加关注患者目标和价值观的多样性，以及在DBS治疗过程中这些目标不断变化的性质。我们报告了一项实证研究的初步数据，该研究考察了帕金森病患者在接受DBS治疗时的目标。我们认为，从伦理角度出发，有必要对治疗效果进行多方面的长期评估，包括经过充分验证的症状指标、生活质量、功能指标以及患者特定指标，以履行信托和专业职责。这些评估应通过多学科的审议性审查和评估过程加以补充。这种方法将有助于改善知情同意，促进更好的临床研究，并通过提供一个系统机制来获取重要的患者见解并据此采取行动，从而推动良好的患者护理。随着DBS开始应用于神经精神疾病，这些过程变得越来越关键。
