健康状态值不应该被用作最小的重要差异
David Parkin1,2
1City St. George's, University of London, London, UK.
概括
与健康相关的生活质量相关的最小重要差异 (MID) 缺乏上下文,并且具有误导性. 不能将MID集成为组或用于决策,如果没有除了指标本身之外的额外信息.
科学领域:
- 卫生经济学 卫生经济学
- 患者报告的结果
- 生活质量研究 研究 生命质量研究
背景情况:
- 最小重要的差异 (MID) 用于解释与健康相关的生活质量 (HRQoL) 指标的变化.
- 然而,在本文中,将MIDs应用于健康状态值或公用事业进行了批判性研究.
研究的目的:
- 在应用于健康状态值时,批判性地评估最小重要差异 (MID) 的实用性和解释.
- 突出MID在健康结果研究中的上下文限制和潜在误导性.
主要方法:
- 对MID的概念基础和应用进行批判性分析.
- 检查个人MIDs到组级别的聚合.
- 审查患者偏好在健康状况值中的作用.
主要成果:
- MID 缺乏特定背景的含义,不能被视为单独指标的属性.
- 在没有额外的上下文判断的情况下,将单个MID集成到组级别是没有意义的.
- 健康状态值本质上包括患者的偏好,使零成为唯一真正不重要的变化.
结论:
- 计算和报告健康状况值的MID是没有帮助和潜在的误导.
- 多元化诊断需要额外的背景 (例如,成本效益) 来进行有意义的临床和研究决策.
- 解释HRQoL变化需要一个更广泛的视角超越MID本身.
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