Basing drug scheduling decisions on scientific ranking of harmfulness: false promise from false premises
Basing drug scheduling decisions on scientific ranking of harmfulness: false promise from false premises
复制标题
DOI：
10.1111/j.1360-0443.2011.03461.x
复制
发表时间：
2011-11-01
期刊：
影响因子：
6
通讯作者：
Coulson, Carolyn
中科院分区：
文献类型：
--
作者：
Caulkins, Jonathan P.;Reuter, Peter;Coulson, Carolyn
近年来，许多研究试图通过单一的危害性指标对药物进行排名，作为决定药物治疗计划和分类的基础。这些努力在概念和方法上都存在根本性的缺陷。试图提供一种单一的衡量标准掩盖了相关的各种不可比较的方面，掩盖了大多数但并非所有药物的益处被忽视的事实，以及药物的危害并非对所选择的政策制度不变的事实。从方法论上讲，最近最突出的努力忽视了药物相互作用，并不适当地混合了总体和个体伤害。相反，我们建议需要展示伤害的多个维度，以告知人类应该安排哪些药物的判断。危害是没有有效地减少到一个单一的维度，甚至完美的排名将不会构成一个“足够的统计”，以确定调度决策。
In recent years a number of studies have attempted to rank drugs by a single measure of harmfulness as the basis for decisions about scheduling and classification. These efforts are fundamentally flawed, both conceptually and methodologically. The effort to provide a single measure masks the variety of non-comparable dimensions that are relevant, the fact that benefits are ignored for most, but not all, drugs and that the harms of a drug are not invariant to the policy regime chosen. Methodologically, the most prominent recent effort ignores drug interactions and mixes aggregate and individual harms inappropriately. Instead we suggest that multiple dimensions of harm need to be displayed to inform human judgments of what drugs should be scheduled. Harm is not usefully reducible to a single dimension, and even perfect rankings would not constitute a 'sufficient statistic' for determining scheduling decisions.