The Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Med Care Res Rev. 2013 Feb;70(1 Suppl):50S-79S. doi: 10.1177/1077558712461182. Epub 2012 Nov 1.
Providing a patient with decision support involves helping that person to choose among two or more elective health care options. "Values Clarification" and "Preference Elicitation" are integral to the full decision-support process. During values clarification, the patient and clinician gain insight into the importance that the patient ascribes to the options' positive and negative characteristics. During preference elicitation, the patient identifies which options are, overall, personally most favored (and, by corollary, which are least favored). This article identifies the roles that values clarification/preference elicitation (VC/PE) play in the full process of patients' decision support, outlines various approaches to fostering VC/PE, and poses some fundamental and applied research questions about VC/PE. It also argues that, in order to proceed to answer the posed research questions, investigators in the field of patients' decision support require a systematic set of criteria for comparing the performance of different VC/PE techniques.
为患者提供决策支持包括帮助患者在两种或更多种可选的医疗保健方案中做出选择。“价值观澄清”和“偏好发掘”是完整决策支持过程的组成部分。在价值观澄清过程中,患者和临床医生深入了解患者对方案的积极和消极特征的重视程度。在偏好发掘过程中,患者确定哪些方案总体上是个人最青睐的(相应地,哪些方案是最不青睐的)。本文确定了价值观澄清/偏好发掘(VC/PE)在患者决策支持的整个过程中所扮演的角色,概述了促进 VC/PE 的各种方法,并提出了一些关于 VC/PE 的基础和应用研究问题。它还认为,为了回答提出的研究问题,患者决策支持领域的研究人员需要一套系统的标准来比较不同 VC/PE 技术的性能。