Frankfurt School of Finance and Management, Sonnemannstr. 9-11, 60314, Frankfurt am Main, Germany.
Eur J Health Econ. 2018 Jan;19(1):167-172. doi: 10.1007/s10198-017-0916-4.
The evidence-based medicine (EBM) movement has long acknowledged the relevance of patient preferences and values. According to EBM, clinicians first clarify the medical evidence about the benefits and burdens of the treatment in question and then, as a second step, elicit values and preferences from patients. Importantly, however, values are placed on patient-relevant outcomes. Surrogate endpoints are only used if their validity is proven. This article shows that some recent patient-preference studies attribute value to surrogate endpoints even when there is no improvement in patient-relevant outcomes. The article points out their foundation in neoclassical economics and discusses their clash with principles of EBM and medical ethics.
循证医学（EBM）运动长期以来一直承认患者偏好和价值观的相关性。根据 EBM，临床医生首先澄清有关治疗益处和负担的医学证据，然后作为第二步，从患者那里引出价值观和偏好。然而，重要的是，价值观是基于患者相关的结果。只有在证明替代终点的有效性后，才会使用替代终点。本文表明，一些最近的患者偏好研究即使在患者相关结果没有改善的情况下，也会赋予替代终点价值。本文指出了它们在新古典经济学中的基础，并讨论了它们与 EBM 和医学伦理原则的冲突。
