试验一种新的方法,通过直观的权衡来估计医学中的行动值
Bart K M Jacobs1, Alfred Kipyegon Keter2,3,4, Aquiles Rodrigo Henriquez-Trujillo2,5
1Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium bkjacobs@itg.be.
BMJ evidence-based medicine
|August 30, 2023
概括
医生在不确定性下使用临床决策的行动值. 一种新方法,即调整名义组技术 (aNGT) 进行了试点测试,并显示了在利益相关方同意下有效估计这些值的潜力.
科学领域:
- 临床决策 - 临床决策
- 医学上的不确定性
- 卫生政策 卫生政策
背景情况:
- 医生根据疾病的概率开出治疗方案,使用行动值来做出不确定性决策.
- 估计行动值的现有方法往往产生不满意的结果,缺乏临床采用.
- 调整名义组技术 (aNGT) 是一种用于临床决策的新型处方方法.
研究的目的:
- 试用适应的名义组技术 (aNGT) 来估计临床决策中的行动值.
- 评估aNGT在各种临床场景中的可行性和可接受性.
- 将aNGT衍生的值与现有方法的值进行比较.
主要方法:
- 这项研究涉及研究生将aNGT应用于三个临床场景:耐利芬素结核病 (RR-TB) 治疗,二线艾滋病毒治疗和SARS-CoV-2隔离.
- 参与者确定并评价了不正确行动的危害,然后权衡这些危害以确定共识值.
- 值被计算为假阳性伤害与总伤害的比率,在参与者中平均.
主要成果:
- 对RR-TB治疗的行动值估计超过50%,对HIV治疗为20-50%,对COVID-19隔离为43%.
- 参与者发现,由此产生的值是可以接受的,会议间的差异低至中等.
- 通过aNGT估计的值比从临床细节法中得出的值略低.
结论:
- 试点研究表明aNGT是一种可行和有效的方法,用于估计临床决策中的行动值.
- aNGT有潜力促进利益相关者之间就可接受的决策门达成共识.
- 需要进一步的研究来验证aNGT在现实临床实践中的实用性和通用性.
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