Stiggelbout A M, Kiebert G M, Kievit J, Leer J W, Habbema J D, De Haes J C
Medical Decision Making Unit, University Hospital Leiden, The Netherlands.
J Clin Epidemiol. 1995 Oct;48(10):1207-14. doi: 10.1016/0895-4356(95)00011-r.
We examined the feasibility and the proportional trade-off assumption of the Time Trade-Off method. Utilities were assessed of the actual health states of 54 testicular and 72 colorectal cancer patients, treated with the curative intent and 29 incurable colorectal cancer patients. Three periods of time were used to assess proportionality: the subject's life expectancy and two shorter periods. Results showed the method to be feasible in curatively treated patients, though the use of life expectancy posed difficulties in some very old subjects. This same difficulty was encountered in patients with symptomatic incurable disease. A two step procedure is proposed as a solution. The proportional trade-off assumption was violated. Utilities for the longer period were smaller than those for the shorter periods. Life expectancy and trade-off did not correlate, though. Remarkable was that many patients were unwilling to trade at all. The implications of the findings are discussed.
我们研究了时间权衡法的可行性和比例权衡假设。对54名睾丸癌患者、72名接受根治性治疗的结直肠癌患者以及29名无法治愈的结直肠癌患者的实际健康状态进行了效用评估。使用三个时间段来评估比例性：受试者的预期寿命和两个较短的时间段。结果表明，该方法在接受根治性治疗的患者中是可行的，尽管在一些高龄受试者中使用预期寿命存在困难。在有症状的无法治愈疾病的患者中也遇到了同样的困难。建议采用两步程序作为解决方案。比例权衡假设被违背。较长时间段的效用小于较短时间段的效用。然而，预期寿命和权衡之间没有相关性。值得注意的是，许多患者根本不愿意进行权衡。讨论了这些发现的意义。
