Pauker S G, Pauker S P, McNeil B J
Med Decis Making. 1981;1(2):103-14. doi: 10.1177/0272989X8100100202.
The quantitative use of patients' attitudes in medicine has thus far been limited to decisions involving either treatment alternatives or the use or nonuse of a particular diagnostic test. Preference theory has not been applied either to the use of screening tests or to the development of large-scale health-related public policy decisions. In this paper we have, in a prototypical fashion, analyzed the effect patient attitudes have on a public policy decision faced by many countries today--whether or not to institute a screening program for neural tube defects. We have assessed the attitudes of 338 prospective parents toward many of the sequelae expected from the introduction, or lack thereof, of the alpha-fetoprotein screening program--induced abortion from amniocentesis, elective abortion, and the birth of a defective child. Using these data and information collected by the United Kingdom study on alpha-fetoprotein, we have estimated the proportion of patients coming to genetic counseling who would benefit from the availability of a screening program for neural tube defects.
到目前为止，在医学中对患者态度的定量运用仅限于涉及治疗方案选择或特定诊断测试使用与否的决策。偏好理论尚未应用于筛查测试的使用或大规模健康相关公共政策决策的制定。在本文中，我们以一种典型的方式分析了患者态度对当今许多国家面临的一项公共政策决策的影响——是否实施神经管缺陷筛查项目。我们评估了338位准父母对甲胎蛋白筛查项目实施或未实施所预期的许多后遗症的态度，这些后遗症包括羊膜穿刺术导致的人工流产、选择性流产以及有缺陷孩子的出生。利用这些数据以及英国关于甲胎蛋白的研究所收集的信息，我们估计了前来接受遗传咨询的患者中，将从神经管缺陷筛查项目中受益的比例。
