Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
School of Medicine, Nathan Campus, Griffith University, Brisbane, Australia.
Obes Surg. 2018 Jun;28(6):1745-1752. doi: 10.1007/s11695-017-3089-4.
It is important that guidelines and criteria used to prioritise access to bariatric surgery are informed by the values of the tax-paying public in combination with the expertise of healthcare professionals. Citizens' juries are increasingly used around the world to engage the public in healthcare decision-making. This study investigated citizens' juries about prioritising patient access to bariatric surgery in two Australian cities.
The objective of this study is to examine public priorities for government expenditure on the surgical management of obesity developed through either a one or three-day citizen jury.
SUBJECTS/METHODS: A three-day jury was held in Brisbane and a one-day jury in Adelaide. Jurors were selected in Brisbane (n = 18) and in Adelaide (n = 12) according to pre-specified criteria. Expert witnesses from various medical disciplines and consumers were cross-examined by jurors.
The verdicts of the juries were similar in that both juries agreed bariatric surgery was an important option in the management of obesity and related comorbidities. Recommendations about who should receive treatment differed slightly across the juries. Both juries rejected the use of age as a rationing tool, but managed their objections in different ways. Participants' experiences of the jury process were positive, but our observations suggested that many variables may influence the nature of the final verdict.
Citizen's juries, even when shorter in duration, can be an effective tool to guide the development of health policy and priorities. However, our study has identified a range of variables that should be considered when designing and running a jury and when interpreting the verdict.
优先考虑接受减重手术的指导方针和标准，不仅要结合医疗保健专业人员的专业知识，还要考虑纳税公众的价值观，这一点非常重要。公民陪审团在世界各地越来越多地被用于让公众参与医疗保健决策。本研究调查了澳大利亚两个城市的公民陪审团对优先考虑患者接受减重手术的意见。
本研究的目的是通过一天或三天的公民陪审团来审查公众对政府用于肥胖症手术管理的支出的优先事项。
受试者/方法：在布里斯班举行了为期三天的陪审团，在阿德莱德举行了为期一天的陪审团。布里斯班（n=18）和阿德莱德（n=12）的陪审员是根据预先规定的标准挑选的。来自不同医学专业的专家证人和消费者接受了陪审员的盘问。
陪审团的裁决相似，两个陪审团都同意减重手术是肥胖及其相关并发症管理的重要选择。关于谁应该接受治疗的建议在陪审团之间略有不同。两个陪审团都拒绝将年龄作为配给工具，但以不同的方式处理了他们的反对意见。参与者对陪审团程序的体验是积极的，但我们的观察表明，许多变量可能会影响最终裁决的性质。
即使是短期的公民陪审团也可以成为指导卫生政策和优先事项制定的有效工具。然而，我们的研究已经确定了在设计和运行陪审团以及解释裁决时应考虑的一系列变量。
