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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
根拠に基づいた医療における視点の必要性
1Department of Family Practice, Medical College of Virginia, Virginia Commonwealth University, Fairfax 22033, USA. shwoolf@aol.com
JAMA
|December 28, 1999
まとめ
医療の優先順位は不一致で,予防よりも治療への支出が多くなっています. 介入の有効性,援助政策,個人の健康に関する決定を比較するための新しいシステムが提案されています.
科学分野:
- 医療サービス 研究 医療サービス
- 医療情報工学 医療情報工学
- 公共衛生政策 公共衛生政策
背景:
- 増加する臨床試験のデータは,体系的な情報合成の必要性を強調しています.
- 現在の医療制度は,政策と個人の意思決定のための介入の有効性を比較するためのリソースが不足しています.
- 不一致した優先順位が存在し,主要な予防と健康促進よりも疾患治療に多額の支出が行われています.
研究 の 目的:
- 医療介入の相対的な効果を比較するためのシステムを提案する.
- 政策立案者,臨床医,および個人が,証拠に基づいた介入の優先順位を決められるようにする.
- 医療におけるエビデンスに基づく予測の緊急の必要性を解決する.
主な方法:
- 図書館的証拠収集センター開発.
- 介入の利益と害を推定するためのシミュレーションモデリング.
- 主要予防と治療の有効性の比較分析.
主要な成果:
- 主要予防戦略 (例えば,禁煙,運動) は,心臓血管疾患の治療よりも死亡率の減少の可能性を示しています.
- 現在の医療費は,予防よりも治療を優先する.
- 個別レベルの分析は,患者が情報に基づいた健康選択をできるようにすることができます.
結論:
- 証拠の評価に対する体系的なアプローチは,医療の優先順位を人口の健康ニーズと整合させる上で極めて重要です.
- 提案されたエビデンス収集とシミュレーションツールは,リソースの割り当てと臨床実践を導くことができます.
- 証拠に基づいたプライマリ予防を優先することは,全体的な健康結果を改善するために不可欠です.
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