Evidera,Waltham,Massachusetts;McGill University.
Evidera.
Int J Technol Assess Health Care. 2018 Jan;34(1):105-110. doi: 10.1017/S0266462317001118. Epub 2017 Dec 26.
Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered.
This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences.
The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported.
The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.
患者偏好应成为医疗保健决策制定的核心考虑因素。然而,患者对监管和报销决策提出质疑的故事引发了人们对在这些决策过程中是否充分考虑患者意见的质疑。这导致一些人认为,在充分考虑患者偏好之前,有必要对其进行量化。
本研究考虑了多准则决策分析(MCDA)在努力量化患者偏好方面的经验教训。它定义了 MCDA,并总结了它可以为决策者提供的好处,确定了涉及患者的 MCDA 示例,并总结了与量化患者偏好相关的良好实践指南。
为支持在医疗保健中使用 MCDA 而制定的指导方针为量化患者偏好提供了一些有用的考虑因素,即研究人员应适当考虑:患者偏好的异质性及其与决策者的相关性;不同启发式方法带来的认知挑战;以及他们产生的结果的有效性。此外,重要的是要考虑这些考虑因素的相关性如何随所支持的决策而变化。
MCDA 文献为量化患者偏好以支持医疗保健决策提供了重要经验。