Lenert L A, Morss S, Goldstein M K, Bergen M R, Faustman W O, Garber A M
Department of Medicine, Stanford University School of Medicine, California 94305-5113, USA.
Med Care. 1997 Sep;35(9):915-20. doi: 10.1097/00005650-199709000-00004.
The authors evaluate a measure of the validity of utility elicitations and study the potential effects of invalid elicitations on population utility values.
The authors used a computerized survey to describe and measure preferences for three common side-effects of anti-psychotic drugs (tardive dyskinesia [TD], akathesia [AKA], pseudo-parkinsonism). The authors compared the validity of elicitations in 41 healthy volunteers to 22 schizophrenic patients. Preferences were measured using visual analog scale (VAS), pair-wise comparison (PWC), and the Standard Gamble (SG) methods. To assess the validity of each groups' responses, the authors compared the consistency of subjects' rank-order of the desirability of states across methods of preferences assessment (CAMPA).
All healthy volunteers and 82% of patients completed the computer survey; of these subjects, 97% of healthy volunteers and 70% of patients indicated they thought they understood the task required of them. However, only 78% of healthy subjects and 44% of patients had a consistent rank ordering of preferences among VAS and PWC ratings; only 80% and 61%, respectively, had a consistent rank ordering preferences among SG and PWC ratings. For two of the three health states, inconsistent subjects had statistically higher SG utilities (for TD, 0.94 versus 0.87, and for AKA 0.92 versus 0.86; P < 0.05).
The CAMPA test can identify potentially invalid preference ratings. Potentially invalid preference ratings may bias the "population" utilities for health states.
作者评估效用诱导有效性的一种测量方法,并研究无效诱导对总体效用值的潜在影响。
作者使用计算机化调查来描述和测量抗精神病药物三种常见副作用(迟发性运动障碍[TD]、静坐不能[AKA]、假性帕金森症)的偏好。作者将41名健康志愿者与22名精神分裂症患者的诱导有效性进行比较。使用视觉模拟量表(VAS)、成对比较(PWC)和标准博弈(SG)方法测量偏好。为评估每组反应的有效性,作者比较了不同偏好评估方法(CAMPA)下受试者对状态可取性的排序一致性。
所有健康志愿者和82%的患者完成了计算机调查;在这些受试者中,97%的健康志愿者和70%的患者表示他们认为自己理解了要求他们完成的任务。然而,只有78%的健康受试者和44%的患者在VAS和PWC评分之间具有一致的偏好排序;在SG和PWC评分之间,分别只有80%和61%的患者具有一致的偏好排序。对于三种健康状态中的两种,排序不一致的受试者在统计学上具有更高的SG效用(对于TD,0.94对0.87,对于AKA,0.92对0.86;P<0.05)。
CAMPA测试可以识别潜在无效的偏好评分。潜在无效的偏好评分可能会使健康状态的“总体”效用产生偏差。