Lenert L A, Soetikno R M
Department of Medicine, Stanford University School of Medicine, CA, USA.
J Am Med Inform Assoc. 1997 Jan-Feb;4(1):49-56. doi: 10.1136/jamia.1997.0040049.
To assess the practicality of an automated computer interview as a method to assess preferences for use in decision making. To assess preferences for outcomes of deep vein thrombosis (DVT) and its treatment.
A multimedia program was developed to train subjects in the use of different preference assessment methods, presented descriptions of mild post-thrombotic syndrome (PTS), severe PTS and stroke and elicited subject preferences for these health states. This instrument was used to measure preferences in 30 community volunteers and 30 internal medicine physicians. We then assessed the validity of subject responses and calculated the number of quality-adjusted life years (QALYs) for each individual for each alternative.
All subjects completed the computerized survey instrument without assistance. Subjects generally responded positively to the program, with volunteers and physicians reporting similar preferences. Approximately 26.5% of volunteers and physicians had preferences that would be consistent with the use of thrombolysis. Individualization of therapy would lead to the most QALYs.
Utilization of computerized survey instruments to elicit patient preferences appears to be a practical and valid approach to individualize therapy. Application of this method suggests that there may be many patients with DVT for whom treatment with a thrombolytic drug would be optimal.
评估自动化计算机访谈作为一种用于决策制定的偏好评估方法的实用性。评估对深静脉血栓形成(DVT)及其治疗结果的偏好。
开发了一个多媒体程序,用于培训受试者使用不同的偏好评估方法,呈现轻度血栓后综合征(PTS)、重度PTS和中风的描述,并引出受试者对这些健康状态的偏好。该工具用于测量30名社区志愿者和30名内科医生的偏好。然后,我们评估了受试者回答的有效性,并计算了每个个体每种选择的质量调整生命年(QALY)数量。
所有受试者均在无协助的情况下完成了计算机化调查工具。受试者对该程序总体反应积极,志愿者和医生报告的偏好相似。约26.5%的志愿者和医生的偏好与使用溶栓治疗一致。个体化治疗将带来最多的QALY。
利用计算机化调查工具来引出患者偏好似乎是一种实用且有效的个体化治疗方法。这种方法的应用表明,可能有许多DVT患者使用溶栓药物治疗是最佳选择。