Roberts J S, Watrous M L, Schulz R M, Mauch R P, Nightengale B S
Center for Drug and Alcohol Programs, Institute of Psychiatry, Medical University of South Carolina, Charleston 29425, USA.
Ann Pharmacother. 1996 Sep;30(9):926-34. doi: 10.1177/106002809603000902.
To develop a precise, interval level scale of the clinical significance of drug-drug interactions that reflects the professional judgments of practicing pharmacists.
A convenience sample of 63 practicing pharmacists representing hospital (clinical and staff) and retail (chain and independent) practice settings.
Pharmacists judged the similarity among 15 interaction categories that have been commonly used to classify drug-drug interactions. A multidimensional scaling technique produced a spatial representation (i.e., a psychological map) of the structure inherent in those similarity judgments. Pharmacists' ratings of clinical significance were projected onto that same spatial representation using a multiple regression procedure, and the resulting information was used to develop a scale of clinical significance.
The clinical significance scale developed from pharmacists' judgments was substantially different from a comparison scale published in a popular reference. The new scale was more precise than the comparison scale, and it also approximated an interval level of measurement. The judgments used to produce the new clinical significance scale were not reliably influenced by pertinent demographic characteristics of the sample.
Inconsistencies between published clinical significance scales and the professional judgments of practitioners could affect patient care to the degree that a summary measure of clinical significance affects a practitioner's response to a potential drug-drug interaction. The clinical significance scale developed in this study has good measurement characteristics and reflects the professional judgments of practicing pharmacists. Use of the new scale is recommended on these grounds, although further assessment of its generality is warranted.
制定一个精确的、具有区间水平的药物相互作用临床意义量表，以反映执业药师的专业判断。
选取63名执业药师作为便利样本，他们分别来自医院（临床药师和药师）以及零售药店（连锁药店和独立药店）。
药师对常用于分类药物相互作用的15种相互作用类别之间的相似性进行判断。一种多维标度技术生成了这些相似性判断中所固有的结构的空间表示（即心理地图）。使用多元回归程序将药师对临床意义的评分投影到相同的空间表示上，并利用所得信息制定临床意义量表。
根据药师判断制定的临床意义量表与一本流行参考文献中公布的比较量表有很大不同。新量表比比较量表更精确，并且也近似于区间测量水平。用于生成新临床意义量表的判断不受样本相关人口统计学特征的可靠影响。
已公布的临床意义量表与从业者专业判断之间的不一致可能会影响患者护理，因为临床意义的汇总测量会影响从业者对潜在药物相互作用的反应程度。本研究中制定的临床意义量表具有良好的测量特性，反映了执业药师的专业判断。基于这些理由，建议使用新量表，不过有必要对其通用性进行进一步评估。
