Reed W W, Herbers J E, Noel G L
Department of Medicine, Walter Reed Army Medical Center, Washington, DC.
J Gen Intern Med. 1993 Nov;8(11):591-6. doi: 10.1007/BF02599710.
To assess variability in patients' values and preferences regarding cholesterol-lowering therapy.
A descriptive study. Patients currently receiving cholesterol-lowering therapy were interviewed using the time tradeoff and standard reference gamble techniques of utility assessment.
Internal medicine clinics of a military medical center.
Thirty-five patients, clinically free of coronary disease, receiving cholesterol-lowering therapy for at least three months.
When the time tradeoff method was applied, 12 (34%) of the patients indicated that less than one month of additional life would be a fair return for adhering to their current therapy for the rest of their lives, while 13 (37%) patients required more than one additional year of life, and four (11%) required at least five years. By the standard reference gamble method, 18 (51%) patients would not have accepted a risk of one in a thousand of imminent death (in 30 days) in hopes of obtaining a normal life expectancy off therapy, while 14 (40%) would have agreed to a 1% or greater risk in order to avoid therapy.
While many patients apparently expected very little in return for adhering to therapy, many others may not be getting "what they bargained for."
评估患者在降胆固醇治疗方面的价值观和偏好的变异性。
一项描述性研究。使用效用评估的时间权衡法和标准参考赌博法对目前正在接受降胆固醇治疗的患者进行访谈。
一家军事医疗中心的内科诊所。
35名临床上无冠心病的患者，接受降胆固醇治疗至少三个月。
应用时间权衡法时，12名（34%）患者表示，坚持目前的治疗直到生命结束，获得不到1个月的额外生命就算是公平回报；而13名（37%）患者需要1年以上的额外生命，4名（11%）患者需要至少5年。采用标准参考赌博法时，18名（51%）患者不会接受千分之一的在30天内猝死的风险，以期望在停止治疗后获得正常预期寿命，而14名（40%）患者会同意承担1%或更高的风险以避免治疗。
虽然许多患者显然对坚持治疗的回报期望很低，但其他许多患者可能并未得到“他们所期望的”。
