患者治疗风险耐受性的共识值是多少? 对炎症性肠病的陈述偏好证据基础的评估
F Reed Johnson1, Juan Marcos Gonzalez1, Jui-Chen Yang2
1Department of Population Health Sciences; Preference Evaluation Research Group, Duke Clinical Research Institute.
概括
这项研究证明了建立患者偏好的证据库,以量化治疗疗效的风险耐受性. 它发现了不同的耐风险和不愿风险的患者群体,为未来的研究设计提供了信息.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
- 患者报告的结果
背景情况:
- 声明偏好研究对于了解患者对治疗风险和益处的偏好至关重要.
- 可以利用现有的证据库来综合患者的风险耐受性数据.
- 量化患者对风险耐受性的共识对于个性化药物和基于证据的治疗指南至关重要.
研究的目的:
- 确定创建一个声明偏好证据基础的可行性,以量化患者的风险容忍度.
- 使用开发的证据基础,为设计一个新的选择实验提供信息.
- 在缺乏现有证据的情况下测试假设.
主要方法:
- 从9个离散选择实验研究中汇集和融合了数据,涉及2,247名受访者和25,017个选择题.
- 利用随机参数逻辑,潜伏类模型来识别耐风险和不愿风险的患者类别.
- 采用7个数据集的融合模型来预测持久数据集的最大可接受风险.
主要成果:
- 确定了三个患者类别:耐风险 (53%),不愿风险 (35%) 和统计学上没有信息 (12%).
- 确定共识最大可接受的一年严重感染风险的症状缓解:风险耐受性组9.5%,风险不良组5.8%.
- 融合模型对结合性炎症性肠病 (IBD) 数据的预测性表现良好,但对疾病特定预测的准确性较低.
结论:
- 声明偏好的文献可以成熟,以创建类似于临床研究的证据基础,用于估计共识效应大小.
- 开发和使用声明偏好证据库提供了有价值的利益转移数据.
- 这些证据基础可以识别知识差距,并指导有效的研究设计来解决这些差距.
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