Winn Karen, Ozanne Elissa, Sepucha Karen
MGH Institute of Health Professions, Boston, USA.
The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, USA.
Patient Educ Couns. 2015 Jul;98(7):811-21. doi: 10.1016/j.pec.2015.03.012. Epub 2015 Mar 21.
The purpose was to examine recent advances in measuring value concordance and to highlight best practices.
The paper updates a prior systematic review. A systematic review of the literature from 2008 to 2012 identified articles that reported a relationship between patients' preferences concerning health outcomes and/or medical treatments, and treatment (intended or actual). Relevant articles were independently abstracted by two reviewers.
The search identified 3635 unique citations, the full text of 187 articles was examined, and 63 articles covering 61 studies were included, nearly a third more articles than identified in the original review. There were 72 different value concordance calculations, the majority of which were clearly reported with significance. More studies assessed knowledge, reported on the association between value concordance and knowledge, and included a decision aid compared to those in the original review.
There is increased reporting of value concordance in the literature. However, large differences exist in the way that the measure is defined and calculated. The variability makes it difficult to draw conclusions about the quality of care across studies.
Value concordance is a critical component of patient-centered care, and further attention is needed to establish standards for measurement and reporting.
旨在探讨测量价值一致性方面的最新进展，并突出最佳实践方法。
本文更新了之前的系统评价。对2008年至2012年的文献进行系统评价，筛选出报告患者对健康结局和/或医疗治疗的偏好与治疗（预期或实际）之间关系的文章。两名评审员独立提取相关文章的摘要。
检索到3635条独特的引文，对187篇文章的全文进行了审查，纳入了63篇文章（涵盖61项研究），比原始评价中确定的文章多出近三分之一。有72种不同的价值一致性计算方法其中大多数都明确报告了显著性。与原始评价相比，更多的研究评估了知识，报告了价值一致性与知识之间的关联，并纳入了决策辅助工具。
文献中关于价值一致性的报告有所增加。然而，在测量方法的定义和计算方式上存在很大差异。这种变异性使得难以对各项研究中的医疗质量得出结论。
价值一致性是以患者为中心的医疗的关键组成部分，需要进一步关注以建立测量和报告的标准。
