手段可能会欺骗:比较和对比风险容忍估计从离散选择实验和值技术练习
Jessie Sutphin1, Matthew J Wallace1, Shelby D Reed2
1Preference Evaluation Research (PrefER) Group, Duke Clinical Research Institute, Durham, NC, USA.
概括
这项研究发现,虽然离散选择实验 (DCE) 和值技术 (TT) 显示出相似的平均风险耐受性,但个体患者的结果有很大的差异,影响了医疗器械的决策.
科学领域:
- 卫生经济学 卫生经济学
- 医疗决策的制定 医疗决策的制定
- 患者的偏好 患者的偏好
背景情况:
- 了解患者的风险承受能力对于医疗器械采用和医疗保健政策至关重要.
- 偏好诱导方法用于量化患者的风险容忍度,但它们的一致性需要评估.
研究的目的:
- 为了比较离散选择实验 (DCE) 和值技术 (TT) 之间的定量风险耐受度.
- 评估从DCE和TT方法获得的患者风险耐受度估计的一致性和不一致性.
主要方法:
- 一项调查显示,对于外围动脉疾病的再血管化装置,存在利益风险权衡.
- 5年死亡率的最大可接受风险 (MAR) 增加是关键指标,DCE和TT作为诱导方法.
- 用混合逻辑和间隔回归模型分析数据,并对调查设计特征进行灵敏度分析.
主要成果:
- 从DCE和TT获得的平均MAR估计在整个样本 (N=249) 中是相似的 (<1个百分点差异).
- 在48.2%的受访者中,个人水平的MAR估计显示出不一致 (>2个百分点).
- DCE和TT演习的顺序影响了MAR估计,但通信方法和DCE设计没有.
结论:
- DCE和TT方法在估计平均风险承受能力时显示出样本级一致性.
- 在DCE和TT方法之间存在显著的个人层面的不一致,这表明在个人患者决策中应用这些措施时要谨慎.
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