Debating Clinical Utility
Debating Clinical Utility
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DOI：
10.1159/000279623
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Press, N.
中科院分区：
文献类型：
--
作者：
Burke, W.;Laberge, A. -M.;Press, N.
基因检测的临床效用取决于检测使用后的结果。像其他价值衡量标准一样，它经常受到质疑。利益攸关方可能对利益和风险以及社会与健康结果的重要性有不同的看法。他们通常也不同意所需的证据，以确定是否测试是有效地实现特定的结果。问题可能会以事实分歧的形式出现，而实际上它们是关于什么信息重要或在临床决策中应如何解释和使用事实的辩论。因此，界定所涉的不同问题是决策的一个重要因素。关键问题包括测试使用的证据标准，特别是在何种情况下应要求前瞻性对照数据，以及测试的可行性，成本和公平交付的证据;以人口为基础的筛查计划的目标，特别是社会成果在评估测试价值的作用;以及适当的使用和资助的测试，告知非医疗行动。解决这些问题需要关注利益相关者的价值观和有效审议的方法，包括消费者以及卫生专业人士的观点。版权所有（C）2010 S. Karger AG，巴塞尔
The clinical utility of genetic tests is determined by the outcomes following test use. Like other measures of value, it is often contested. Stakeholders may have different views about benefits and risks and about the importance of social versus health outcomes. They also commonly disagree about the evidence needed to determine whether a test is effective in achieving a specific outcome. Questions may be presented as factual disagreements, when they are actually debates about what information matters or how facts should be interpreted and used in clinical decision-making. Defining the different issues at stake is therefore an important element of policy-making. Key issues include evidence standards for test use, and in particular, the circumstances under which prospective controlled data should be required, as well as evidence on feasibility, cost and equitable delivery of testing; the goals of population-based screening programs, and in particular, the role of social outcomes in evaluating test value; and the appropriate uses and funding of tests that inform non-medical actions. Addressing each of these issues requires attention to stakeholder values and methods for effective deliberation that incorporate consumer as well as health professional perspectives. Copyright (C) 2010 S. Karger AG, Basel