Preferences of diabetes patients and physicians: a feasibility study to identify the key indicators for appraisal of health care values.
Preferences of diabetes patients and physicians: a feasibility study to identify the key indicators for appraisal of health care values.
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DOI：
10.1186/1477-7525-8-125
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发表时间：
2010-11-04
影响因子：
3.6
通讯作者：
Hippler HJ
中科院分区：
文献类型：
--
作者：
Porzsolt F;Clouth J;Deutschmann M;Hippler HJ
循证医学、医学研究所（IOM）和德国卫生保健质量和效率研究所（IQWiG）支持将患者的偏好纳入卫生保健决策。事实上，没有多少试验包括对患者偏好的评估。本研究的目的是证明医生和患者的偏好可以评估，这些信息可能有助于医疗决策。联合分析法是评价偏好的一种既定方法。联合分析，结合计算机辅助电话采访（CATI），被用来收集数据，从827例糖尿病患者和60名医生，其中描述的偏好表示为水平的四个因素的管理和结果的疾病。第一个因素描述了主要的治疗效果（HbA1c升高降低，健康状况改善，无副作用，日常生活无限制）。第二个因素描述了对体重的影响（增加、无变化、减少）。第三个因素分析了申请方式（与膳食或灵活申请有关）。第四个因素涉及产品的类型（原品牌或通用产品）。效用值以所有水平的效用点之和等于属性（因子）数量乘以100的方式进行缩放和归一化。偏好权重证实，对于患者（尤其是肥胖患者）和医生而言，体重减轻至少与HbA1c升高降低同样重要。患者更喜欢原研产品，而全科医生更喜欢仿制产品。以糖尿病为例，可以评估患者和医生偏好之间的差异。结合CATI的联合分析的使用似乎是一种有效的方法来生成的数据，需要在医疗保健的政策和医疗决策。
Evidence-based medicine, the Institute of Medicine (IOM) and the German Institute for Quality and Efficiency in Health Care (IQWiG), support the inclusion of patients' preferences in health care decisions. In fact there are not many trials which include an assessment of patient's preferences. The aim of this study is to demonstrate that preferences of physicians and of patients can be assessed and that this information may be helpful for medical decision making. One of the established methods for assessment of preferences is the conjoint analysis. Conjoint analysis, in combination with a computer assisted telephone interview (CATI), was used to collect data from 827 diabetes patients and 60 physicians, which describe the preferences expressed as levels of four factors in the management and outcome of the disease. The first factor described the main treatment effect (reduction of elevated HbA1c, improved well-being, absence of side effects, and no limitations of daily life). The second factor described the effect on the body weight (gain, no change, reduction). The third factor analyzed the mode of application (linked to meals or flexible application). The fourth factor addressed the type of product (original brand or generic product). Utility values were scaled and normalized in a way that the sum of utility points across all levels is equal to the number of attributes (factors) times 100. The preference weights confirm that the reduction of body weight is at least as important for patients - especially obese patients - and physicians as the reduction of an elevated HbA1c. Original products were preferred by patients while general practitioners preferred generic products. Using the example of diabetes, the difference between patients' and physicians' preferences can be assessed. The use of a conjoint analysis in combination with CATI seems to be an effective approach for generation of data which are needed for policy and medical decision making in health care.
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影响因子：
6.1
作者：
KAHNEMAN, D;TVERSKY, A
通讯作者：
TVERSKY, A
影响因子：
105.7
作者：
Ryan, M;Farrar, S
通讯作者：
Farrar, S
影响因子：
7.2
作者：
Thorpe, Kevin E.;Zwarenstein, Merrick;Chalkidou, Kalipso
通讯作者：
Chalkidou, Kalipso
影响因子：
3.2
作者：
Montori, VM;Gafni, A;Charles, C
通讯作者：
Charles, C
影响因子：
3
作者：
Chin, Marshall H.;Drum, Melinda L.;Meltzer, David O.
通讯作者：
Meltzer, David O.