Another look at outcomes and outcome measures in psychiatry: cui bono?
Another look at outcomes and outcome measures in psychiatry: cui bono?
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对精神病学结果和结果测量的另一种观察：cui bono？
DOI：
10.1159/000353462
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发表时间：
2014
影响因子：
22.8
通讯作者：
Balon,Richard
中科院分区：
文献类型：
--
作者：
Arfken,CynthiaL;Balon,Richard
在科克伦协作网的网页[1]上，访问者会遇到这样的问题：你如何知道一种治疗方法是否比另一种更有效，或者它是否弊大于利？这个问题是所有领域临床护理和以患者为导向的研究的核心。这个问题同样适用于精神病学，也适用于其他医学领域。Yusuf等人提供了回答这个问题的方法。[2]通过“问一个重要的问题”和“可靠地回答它”的建议，除了他们的建议，我们还问了西塞罗的一个著名问题：“你好吗？- 目前谁真正受益于这个问题的答案，谁也应该受益？在这篇评论中，我们提倡使用更简单的措施和更生态有效的设计来回答这个中心问题，既可靠又容易理解的病人和他们的家人。[2]没有写的心理测量学性质的规模，甚至不同的方法来衡量其有效性或可靠性。他们正在解决的基本需要是回答什么样的治疗方法比另一种更有效。拥有有效和可靠的量表很重要，我们并不反对使用它们。然而，精神病学中常用的量表很难被患者、家属和决策者理解。精神病学中使用的大多数测量方法（可能是临床总体印象量表以外的任何东西）都不能为公众提供简单易懂的答案。我们显然需要制定患者、家庭和政策制定者都能理解的结果。
On the Cochrane Collaboration webpage [1], visitors are met with the question: How do you know if one treatment will work better than another, or if it will do more harm than good? This question is at the core of clinical care and patient-oriented research in all fields. The question applies equally to psychiatry as it does to other fields of medicine. The approach to answering this question was supplied by Yusuf et al.[2] almost 30 years ago through the advice of ‘ask an important question'and ‘answer it reliably'. To their advice we add asking Cicero's famous question,‘Cui bono?'-Who really benefits from answers to this question currently and who should benefit (as well)? In this commentary we advocate using simpler measures and more ecologically valid designs to answer this central question both reliably and understandably for patients and their families.Contrary to the many contemporary articles focused on ‘reliability', Yusuf et al.[2] did not write on the psychometric properties of scales or even different ways to measure their validity or reliability. They were addressing the fundamental need to answer what treatment will work better than another. Having valid and reliable scales is important, and we are not arguing against their use. However, the scales commonly used in psychiatry are difficult to understand by patients, families and policymakers. Most measures used in psychiatry (probably anything beyond the Clinical Global Impression scale) do not provide simple and understandable answers for the public. We clearly need to develop outcomes that are understandable to patients, families and policymakers.