Thompson Harmony, Chan Huan, Logan Florence J, Heenan Helen F, Taylor Lynne, Murray Chris, Florkowski Christopher M, Frampton Christopher M A, Lunt Helen
Diabetes Centre, 550 Hagley Avenue, PO Box 4710, Christchurch, New Zealand.
N Z Med J. 2013 Nov 22;126(1386):90-7.
Health consumer's input into assessment of medical device safety is traditionally given either as part of study outcome (trial participants) or during post marketing surveillance. Direct consumer input into the methodological design of device assessment is less common. We discuss the difference in requirements for assessment of a measuring device from the consumer and clinician perspectives, using the example of hand held glucose meters. Around 80,000 New Zealanders with diabetes recently changed their glucose meter system, to enable ongoing access to PHARMAC subsidised meters and strips. Consumers were most interested in a direct comparison of their 'old' meter system (Accu-Chek Performa) with their 'new' meter system (CareSens brand, including the CareSens N POP), rather than comparisons against a laboratory standard. This direct comparison of meter/strip systems showed that the CareSens N POP meter read around 0.6 mmol/L higher than the Performa system. Whilst this difference is unlikely to result in major errors in clinical decision making such as major insulin dosing errors, this information is nevertheless of interest to consumers who switched meters so that they could maintain access to PHARMAC subsidised meters and strips. We recommend that when practical, the consumer perspective be incorporated into study design related to medical device assessment.
传统上,健康消费者对医疗设备安全性评估的投入,要么作为研究结果的一部分(试验参与者),要么在上市后监测期间给出。消费者直接参与设备评估的方法设计则不太常见。我们以手持式血糖仪为例,从消费者和临床医生的角度讨论测量设备评估要求的差异。最近,大约8万名新西兰糖尿病患者更换了他们的血糖仪系统,以便能够持续使用由新西兰药品管理局(PHARMAC)补贴的血糖仪和试纸。消费者最感兴趣的是将他们的“旧”血糖仪系统(罗氏卓越型血糖仪)与“新”血糖仪系统(爱康全品牌,包括爱康全N POP型血糖仪)进行直接比较,而不是与实验室标准进行比较。这种血糖仪/试纸系统的直接比较表明,爱康全N POP型血糖仪的读数比卓越型血糖仪高约0.6毫摩尔/升。虽然这种差异不太可能导致临床决策中的重大错误,如重大胰岛素剂量错误,但对于更换血糖仪以便能够继续使用由PHARMAC补贴的血糖仪和试纸的消费者来说,这一信息仍然很重要。我们建议,在实际可行的情况下,应将消费者的观点纳入与医疗设备评估相关的研究设计中。