von Kodolitsch Yskert, Bernhardt Alexander M, Robinson Peter N, Kölbel Tilo, Reichenspurner Hermann, Debus Sebastian, Detter Christian
German Aorta Centre of Hamburg, Centre of Cardiology and Cardiovascular Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Institute of Medical Genetics and Human Genetics, Charité Universitätsmedizin, Berlin, Germany.
Aorta (Stamford). 2015 Jun 1;3(3):98-107. doi: 10.12945/j.aorta.2015.14.064. eCollection 2015 Jun.
It is the physicians' task to translate evidence and guidelines into medical strategies for individual patients. Until today, however, there is no formal tool that is instrumental to perform this translation.
We introduce the analysis of strengths (S) and weaknesses (W) related to therapy with opportunities (O) and threats (T) related to individual patients as a tool to establish an individualized (I) medical strategy (I-SWOT). The I-SWOT matrix identifies four fundamental types of strategy. These comprise "SO" maximizing strengths and opportunities, "WT" minimizing weaknesses and threats, "WO" minimizing weaknesses and maximizing opportunities, and "ST" maximizing strengths and minimizing threats. Each distinct type of strategy may be considered for individualized medical strategies.
We describe four steps of I-SWOT to establish an individualized medical strategy to treat aortic disease. In the first step, we define the goal of therapy and identify all evidence-based therapeutic options. In a second step, we assess strengths and weaknesses of each therapeutic option in a SW matrix form. In a third step, we assess opportunities and threats related to the individual patient, and in a final step, we use the I-SWOT matrix to establish an individualized medical strategy through matching "SW" with "OT". As an example we present two 30-year-old patients with Marfan syndrome with identical medical history and aortic pathology. As a result of I-SWOT analysis of their individual opportunities and threats, we identified two distinct medical strategies in these patients.
I-SWOT is a formal but easy to use tool to translate medical evidence into individualized medical strategies.
将证据和指南转化为针对个体患者的医疗策略是医生的任务。然而，迄今为止，尚无有助于进行这种转化的正式工具。
我们引入对与治疗相关的优势（S）和劣势（W）以及与个体患者相关的机会（O）和威胁（T）的分析，作为建立个体化（I）医疗策略（I-SWOT）的工具。I-SWOT矩阵确定了四种基本策略类型。这些包括“SO”（最大化优势和机会）、“WT”（最小化劣势和威胁）、“WO”（最小化劣势和最大化机会）以及“ST”（最大化优势和最小化威胁）。每种不同的策略类型都可用于个体化医疗策略的考量。
我们描述了I-SWOT的四个步骤，以建立治疗主动脉疾病的个体化医疗策略。第一步，我们确定治疗目标并识别所有基于证据的治疗选择。第二步，我们以SW矩阵形式评估每种治疗选择的优势和劣势。第三步，我们评估与个体患者相关的机会和威胁，最后一步，我们使用I-SWOT矩阵，通过将“SW”与“OT”相匹配来建立个体化医疗策略。作为示例，我们展示了两名患有相同病史和主动脉病变的30岁马凡综合征患者。通过对他们个体机会和威胁的I-SWOT分析，我们在这些患者中确定了两种不同的医疗策略。
I-SWOT是一种将医学证据转化为个体化医疗策略的正式且易于使用的工具。
