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处方药风险感知:欧洲监管网络专家调查结果。

Risk perception of prescription drugs: results of a survey among experts in the European regulatory network.

机构信息

University Medical Center of Groningen (ARMB, PADG, HLH)

London School of Economics and Political Science (ARMB, BF, LDP)

出版信息

Med Decis Making. 2013 May;33(4):579-92. doi: 10.1177/0272989X12472397. Epub 2013 Mar 11.

Abstract

BACKGROUND

Experts are perceived to be veridical and to focus only on objective data when evaluating risk. Only a few research studies have attempted to characterize the subjectivity in risk evaluation among experts.

OBJECTIVE

The hypothesis of this study is that expert evaluation of a pharmaceutical drug can be partly explained by dimensions that describe the drug and by individual characteristics.

DESIGN

Seventy-five medical assessors in 9 EU countries evaluated a list of 28 pharmaceutical drugs using 4 scales: risk, benefit, seriousness of harm, and patients' knowledge of the risk. They were also given a mock "clinical dossier" and asked to rate it on 8 dimensions: risk, benefit, worry, magnitude of the exposure, scientific knowledge of the risk, familiarity of the risk, ethical concerns, and risk acceptability.

RESULTS

Female assessors perceived significantly higher benefits than men for a large number of the 28 drugs. Principal component analysis of the ratings for the clinical dossiers revealed 2 underlying components: seriousness of harm and scientific evidence. A regression model predicting the risk perception of the drug showed that the variables seriousness of harm (benefit, worry, magnitude of exposure, ethical concerns, and risk acceptability), years of regulatory experience, gender, and type of drug explained 54% of the variability among assessors.

CONCLUSION

Assessors' view of the risks associated with pharmaceutical drugs is influenced by worry for patient safety, magnitude of patient exposure, and ethical concerns. These dimensions may influence their perceptions of benefit and risk acceptability. Senior assessors are more risk averse than junior assessors, and female assessors seem to be sensitive to the promise of benefit from medicines and consequently may be less risk averse than male assessors.

摘要

背景

专家被认为是真实的,并且在评估风险时只关注客观数据。只有少数研究试图描述专家在风险评估中的主观性。

目的

本研究的假设是,专家对药物的评估可以部分用描述药物的维度和个体特征来解释。

设计

9 个欧盟国家的 75 名医疗评估员使用 4 个量表评估了 28 种药物的风险、获益、危害严重程度和患者对风险的了解程度:风险、获益、忧虑、暴露程度、对风险的科学认识、风险熟悉度、道德顾虑和风险可接受性。他们还收到了一份模拟的“临床档案”,并被要求根据 8 个维度对其进行评分:风险、获益、忧虑、暴露程度、对风险的科学认识、风险熟悉度、道德顾虑和风险可接受性。

结果

对于大量的 28 种药物,女性评估员认为获益明显高于男性。对临床档案评分的主成分分析显示出两个潜在成分:危害严重程度和科学证据。一个预测药物风险感知的回归模型表明,严重程度(获益、忧虑、暴露程度、道德顾虑和风险可接受性)、监管经验年限、性别和药物类型等变量解释了评估员之间 54%的可变性。

结论

评估员对与药物相关的风险的看法受到对患者安全的担忧、患者暴露程度和道德顾虑的影响。这些维度可能会影响他们对获益和风险可接受性的看法。资深评估员比初级评估员更厌恶风险,女性评估员似乎对药物带来的获益的前景更为敏感,因此可能不像男性评估员那样厌恶风险。

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