决策导刊最新文献

{"title":"Erratum.","authors":"","doi":"10.1177/0272989X19881551","DOIUrl":"https://doi.org/10.1177/0272989X19881551","url":null,"abstract":"","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"30 1","pages":"315"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87437529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Decision Making and MDM Policy & Practice Reviewers, 2018.","authors":"Blythe J. S. Adamson, P. Adsul, C. Afoakwah, F. Alarid-Escudero, D. Alden, B. Althouse, L. Andronis, L. Annemans, Adriana Arcia, Omar Ashour, S. Bae, Henry Bailey, G. Baio, Stuart G. Baker, N. Bansback, J. Barnes, J. Barocas, P. Barton, C. Bascoul-Mollevi, J. Bath, A. Bayoumi, B. Biesecker, R. Birger, William Black, S. Blalock, R. Boer, L. Bojke, C. Bonner, Callie L. Brown, W. Bruin, M. Brundage, E. Burger, M. Byrne, Robert Böhm, D. Caldwell, Jonathan Campbell, S. Cantor, M. Capan, R. Caskey, L. Caulley, K. Cavanaugh, T. Caverly, Jennifer L. Cerully, Su‐Hsin Chang, Yao-Hsuan Chen, S. Chhatre, J. Chhatwal, James Codella, T. Comans, N. Cook, A. Cooke, M. Corriere, M. Cozad, Vincenzo Crupi, M. Cuypers, J. Dalton, J. Dana, B. Deniz, D. Walque, B. Dewitt, V. Diaby, Amanda J. Dillard, B. Djulbegovic, B. Doble, Jason Doctor, Lori Dodd, J. Dolan, S. Eckermann, Emily A. Elstad, A. Elstein, L. Engel, E. Engelhardt, E. Enns, Sara L. Eppler, F. Erenay, D. Leaf, T. Fahey, Haidong Feng, Yan Feng, E. Finkelstein, M. Fio","doi":"10.1177/0272989X19830694","DOIUrl":"https://doi.org/10.1177/0272989X19830694","url":null,"abstract":"The editor-in-chief, deputy editor, associate editors, editorial board, and staff of Medical Decision Making and MDM Policy & Practice, the official journals of the Society for Medical Decision Making, acknowledge and thank the following people for their assistance in reviewing manuscripts during 2018. The journals’ success rests in large measure on the quality and promptness of the reviews it receives from these volunteer reviewers. The thorough and detailed expert evaluation of scientific manuscripts submitted to MDM and MDM P&P is an essential contribution to the success and influence of the MDM journals—and we are grateful to all who contribute their time and knowledge. Reviewer names were taken from MDM’s ScholarOne Manuscripts Web site as of January 23, 2019. Reviewers who wish to update their profile information may do so by logging in to their reviewer accounts at: http://mc.manu scriptcentral.com/mdm. To learn more about reviewing manuscripts for the MDM journals, please see: http://mdm.uic.edu/peer-reviewprocess.","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"11 1","pages":"83-85"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84508815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Decision Making and MDM Policy & Practice Reviewers, 2017.","authors":"Blythe J. S. Adamson, M. Agapova, D. Alden, A. Ali, A. Allepuz, B. Althouse, David Anderson, L. Andronis, Jonathan Arnold, Nathaniel J. S. Ashby, Olivia Aspiras, L. Augestad, L. Austin, S. Bae, G. Baio, P. Barr, J. Barton, P. Barton, C. Bascoul-Mollevi, S. Basu, J. Beckstead, H. Bekker, H. B. Gorrod, Andrei M. Belyaev, Kristin M. Berry, C. Betsch, S. Blalock, R. Boer, Robert Böhm, R. Bordley, D. Borenstein, R. Braithwaite, Gary L. Brase, B. Braun, Erica S. Breslau, C. Brettschneider, Callie L. Brown, Michael D. Brown, W. Bruin, M. Byrne, D. Caldwell, Jonathan Campbell, J. Caro, R. Caskey, K. Cavanaugh, T. Caverly, D. Champredon, C. Chang, Su‐Hsin Chang, David Chartash, Gang Chen, P. Cherubini, J. Chhatwal, S. Chrysanthopoulou, L. Cipriano, P. Clarke, M. Clayman, James Codella, Edward T. Cokely, N. Col, A. Coldman, M. Corriere, J. Covey, M. Cuypers, O. Damman, S. Datta, Thomas Davidson, A. Davies, K. Davies, A. Davis, Jennifer Davis, Sarah Davis, E. W. Bekker-Grob, M. Vries, R. Deber, T. Debray, S. Dehmer,","doi":"10.1177/0272989x18764455","DOIUrl":"https://doi.org/10.1177/0272989x18764455","url":null,"abstract":"The editor-in-chief, deputy editor, associate editors, editorial board, and staff of Medical Decision Making and MDM Policy & Practice, the official journals of the Society for Medical Decision Making, acknowledge and thank the following people for their assistance in reviewing manuscripts during 2017. The journals’ success rests in large measure on the quality and promptness of the reviews it receives from these volunteer reviewers. The thorough and detailed expert evaluation of scientific manuscripts submitted to MDM and MDM P&P is an essential contribution to the success and influence of the MDM journals—and we are grateful to all who contribute their time and knowledge. Reviewer names were taken from MDM’s ScholarOne Manuscripts Web site as of January 22, 2018. Reviewers who wish to update their profile information may do so by logging in to their reviewer accounts at: http://mc.manu scriptcentral.com/mdm. To learn more about reviewing manuscripts for the MDM journals, please see: http://mdm.uic.edu/peer-reviewprocess.","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"4 1","pages":"275-276"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83640712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"38th Annual Meeting of the Society for Medical Decision Making.","authors":"Mette H Møller, M. L. Lousdal, I. Kristiansen, M. Kalager, Torbjørn, Wisløff","doi":"10.1177/0272989X16682012","DOIUrl":"https://doi.org/10.1177/0272989X16682012","url":null,"abstract":"s: SMDM 38th Annual Meeting: Vancouver, British Columbia, Canada E2  MEDICAL DECISION MAKING/JANUARY 2017 PS 1-2 HEALTH ECONOMIC EVALUATION OF DISEASE MODIFYING MEDICINES USED FOR MULTIPLE SCLEROSIS Applied Health Economics (AHE) Vida Hamidi, Ph.D, Elisabeth Couto, PhD and Marianne Klemp, MD, PhD, Norwegian Institute of Public Health, Oslo, Norway Purpose: Multiple sclerosis (MS) is one of the most common causes of disability in young adults. Several disease-modifying therapies (DMT) are available for the treatment of MS, but the cost-effectiveness of the different treatments has not been investigated in a Norwegian setting. To ensure the most appropriate MS management, it is important to assess cost-effectiveness of disease modifying medicines used for MS. Method: We developed a probabilistic decision model to assess the cost-effectiveness of thirteen different DMT used for MS. The model simulates the natural history of MS using the state transition methodology. Health states were defined according to the Kurtzke EDSS (0-10). During one model cycle, patients could remain in the current health state, progress to the next more severe state, transition to a secondary-progressive health state, or die. Patients with an EDDS scale of five or lower could also improve to a less severe state, and experience relapse. Complications were also included in the model. Transitional probabilities were derived from published sources and clinical experts’ opinions. Efficacy estimates for annual relapse and disability progression were based on the network meta-analyses of published RCTs identified by a systematic literature search. Quality of life data were extracted from published studies based on a systematic literature search. Treatment costs were estimated based on official Norwegian unit prices. All costs and health benefits were discounted at a rate of 4% per annum. Sensitivity analysis was performed by means of Monte Carlo simulation. Result: Alemtuzumab was more effective and less costly than the other strategies. A scenario analysis that excluded alemtuzumab (the dominant strategy) showed that interferon beta-1b (Extavia), peg-interferon beta-1a and natalizumab could be cost-effective depending on the willingness-to-pay (WTP) threshold. Assuming a WTP below EUR107,000 per QALY gained, Extavia was approximately 40% likely to be the most cost-effective treatment, followed by peginterferon beta-1a (approximately 30% likely). However, more research on efficacy and epidemiologic input parameters would have the greatest impact on reducing decision uncertainty. Conclusion: Change in clinical practice based on the results of cost-effectiveness analysis has a substantial potential to reduce costs associated with MS treatment. PS 1-3 USING COST-EFFECTIVENESS ANALYSIS TO DETERMINE A THRESHOLD FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS Applied Health Economics (AHE) Phuc Le, PhD, MPH and Michael Rothberg, MD, MPH, Medicine Institute Cleve","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"166 1","pages":"E1-E334"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80447981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"31st Annual Meeting of the Society of Medical Decision Making Abstracts.","authors":"K. Noyes, Alina Bajorska, Andre R Chappel, S. Schwid, L. Mehta, G. Robert, Holloway, A. Dick, K. McCaffery, P. Macaskill, D. Perlroth, Robert J. Glass, Vickey J. Davey, A. Garber, D. Owens","doi":"10.1177/0272989X2010302001","DOIUrl":"https://doi.org/10.1177/0272989X2010302001","url":null,"abstract":"TRA-1 FROM TRIALS TO OBSERVATIONAL DATA: MODELING NATURAL AND “UNNATURAL” HISTORY Katia Noyes, PhD, Alina Bajorska, MS, Andre R. Chappel, BA, Steven Schwid, MD, Lahar R. Mehta, MD, BS, Robert G. Holloway, MD, MPH, and Andrew W. Dick, PhD (1)University of Rochester, Rochester, NY, (2)RAND Co., Pittsburgh, PA Purpose: Cost-effectiveness analysis requires comparison of outcomes in treated and untreated populations. Data from randomized clinical trials (RCT) do not provide progression rates representative of the general population, while treatment effects in observational data may be biased due to non-randomization. We developed a novel approach for estimating untreated progression rates by using data from a population-based longitudinal survey, correcting for the effects of patients’ treatments as reported by pivotal trials. Method: We used data from the 2000-2005 Sonya Slifka nationally representative MS cohort. Disease progression was characterized by disability-based disease states and relapses. We modeled probabilities of disease state transitions using a firstorder annual Markov model that adjusted for demographics, disease duration, recent relapse rates, prior states, and the specific disease-modifying therapy (DMT). To estimate transitional probabilities, we developed an iterative multinomial logistic regression algorithm, constraining the effects of DMT to match those reported by RCTs as follows. We selected initial annual treatment factors and estimated first progression probabilities for controls. For those probabilities, using a numerical algorithm, we found new treatment factors that resulted in the same risk ratios of progression as reported by the trials. The new factors were used in the regression model to adjust for DMT effects and to reestimate the probabilities for controls. We continued this process iteratively, until the identified factors for the final control probabilities matched published DMT effects from RCTs. Result: After correcting for the DMT treatment effects and other observable risk factors, the probability of disability progression was greater for estimates based on all MS patients compared to the estimates based on untreated individuals only. The 95% confidence intervals using the entire cohort (including treated and untreated individuals) were narrower than the intervals based on the subsample of untreated patients. Conclusion: Our results indicate that the untreated patients in our study had lower estimates of disease progression than the treated patients would have had if they remained untreated. This suggests that patients who forgo treatment are likely to have milder, slower progressing forms of MS. Correcting for treatment effects in a more inclusive group of patients likely provides a more realistic estimate of disease progression than simply characterizing progression in an untreated cohort. The use of a population-based cohort also improves the precision of disease progression estimates. TRA-2 ESTIMATING PR","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"25 1","pages":"NP1-NP97"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87593653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Index for the 31st Annual Meeting of the Society of Medical Decision Making Abstracts.","authors":"Olaf Gjerløw","doi":"10.1177/0272989X100300021601","DOIUrl":"https://doi.org/10.1177/0272989X100300021601","url":null,"abstract":"Aasland, Olaf Gjerløw NP34 Aballea, Samuel NP58 Abban, Bartholomew K. NP6 Abrams, Richard NP24 Adams, John L. NP33 Ades, A. E. NP19, NP43 Alagoz, Oguzhan NP3, NP18, NP20, NP26 Alam, Fasihul NP4 Alibhai, Shabbir MH NP35 Alistar, Sabina NP5 Allen, Susan M. NP54, NP70 Ament, Andre NP97 Amundsen, Cindy L. NP92 Anderson, Mark NP57 Anglaret, Xavier NP5 Anis, Aslam H. NP73, NP77, NP95 Antoni, Michael NP69 Araújo, Marco A.C. NP50 Arbuckle, Rebecca NP56 Arkes, Hal R. NP23 Arnold, Forest W. NP81 Arnold, Robert M. NP88 Arora, Vineet NP51 Arrick, Bradley A. NP72 Arrigain, Susana NP36 Asch, David A. NP13 Asch, Steven NP51 Aspinall, Sherrie L. NP66 Assasi, Nazila NP61, NP83 Atar, Dan NP16 Augestad, Liv Ariane NP14, NP38 Aursnes, Ivar NP43 Ayala, Carma NP66 Ayer, Turgay NP18, NP20 Ayvaci, Mehmet NP26 Aziz, Natali NP46 Babineaux, Steve M. NP84 Bajorska, Alina NP1 Baker-Ericzen, Mary J. NP24 Balasubramanian, Hari NP25 Barnato, Amber E. NP88 Barnett, Paul G. NP73, NP77, NP95 Barnsley, Jan NP72 Barr, Amanda NP20 Barratt, Alexandra NP22 Barth Jr., William H. NP28 Barton, Bruce NP90 Barton, Pelham M. NP3 Basu, Anirban NP10, NP17, NP24, NP80 Basu, Rituparna NP69 Bateson, Deborah NP53 Batina, Nataliya G. NP3 Bayoumi, Ahmed M. NP73, NP77, NP95 Bekker, Hilary NP84 Belkora, Jeffrey K. NP21, NP31, NP81 Bendavid, Eran NP27, NP75 Benjamin, Laure NP62 Bennett, Carol NP94 Bentley, Tanya G.K. NP40, NP51 Berg, Susan NP72 Bilir, Sara P. NP24 Bischof, Matthias NP76 Blackhouse, Gordon NP61, NP76, NP83 Blake, Kimberly Bosworth NP86 Bleichrodt, Han NP14 Bosch, F. Xavier NP33 Bosch, Johanna L. NP16 Bots, Michiel L. NP44 Braccia, Deborah NP49 Bradbury, Brian D. NP33 Bradlyn, Andrew S. NP86 Brandeau, Margaret L. NP5, NP27, NP48, NP75 Bravata, Dena M. NP48, NP60, NP65, NP79 Brazier, John NP14 Briggs, Andrew NP4 Brinkman, William B. NP23 Brito, João C.M. NP50 Britt, Helena NP70 Brown, Sheldon T. NP73, NP77, NP95 Brundage, Michael NP35 Bryce, Cindy L. NP78 Bryg, David J. NP32, NP49, NP77 Bryg, Robert J. NP32, NP49, NP77 Burke, Natasha NP76 Burnside, Elizabeth S. NP20, NP26 Burt, Ronald S. NP51 Buskens, Erik NP44 Busschbach, Jan J.V. NP78 ByfieldDaCosta, Stacey NP56 Byrne, Margaret M. NP44, NP69 Cahill, Alison NP46 Cairns, Karen J. NP17 Cameron, D. William NP73, NP77, NP95 Campbell, Kaitryn NP61, NP83 Cantrell, C. Ron NP85, NP86 Cao, J. NP82 Carcone, Steven NP9, NP50 Carroll, Aaron E. NP39 Casella, James F. NP90 Caughey, Aaron B. NP11, NP16, NP46, NP54, NP58, NP82, NP91 Chang, Chichang NP67 Chang, Eric NP36 Chang, Yuchiao NP21, NP31, NP81 Chappel, Andre R. NP1 Chen, Hui-Wen NP67 Chen, Wendong NP19 Cheng, Yvonne NP16 Cherepanov, Dasha NP13, NP15, NP40, NP61 Chhatwal, Jagpreet NP20, NP26 Chien, Ching Wen NP48, NP67 Chow, Adam NP77 Christenson, Maria NP69 Chuang, Ling-Hsiang NP38, NP92 Chung, Jeanette W. NP51 Cipriano, Lauren E. NP28 Clark, Melissa A. NP87 Clarke, Judith NP22 Clay, Catharine F. NP63, NP72 Clifford, Gary M. NP33 Cohan, Deborah NP46 Cohen, Russell D. NP84 Colkesen, Ersen B. NP48","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"1 1","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82919515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Law and ethics. Trust as social capital and as encapsulated interests.","authors":"D. Mazur","doi":"10.1177/027298902400448939","DOIUrl":"https://doi.org/10.1177/027298902400448939","url":null,"abstract":"In this article, Fukuyama explores “the range of theoretical approaches that have been used to explain the origins of social trust and its precursor, social capital.” Noting that the phenomenon of trust “has been a subject of inquiry across a broad range of disciplines, including economics, political science, sociology, psychology, and anthropology,” Fukuyama argues that each approach to trust is different and that “there is actually some ground for synthesizing these approaches, since each captures an important part of the phenomenon.” For Fukuyama, “Trust . . . is a psychological state that is epiphenomenal to the more basic concept of social capital.” For Fukuyama, “Social capital consists of norms or values instantiated in an actual relationship among two or more people, that promote cooperation between them.” For Fukuyama, “A group of people embedding such norms will tend to trust one another more than those who do not, or will at least have been grounds for coming to a decision on whether to trust.”","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"19 1","pages":"372"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74364950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of baseline risk information on social and individual choices.","authors":"D. Gyrd-Hansen, I. Kristiansen, J. Nexøe, J. Nielsen","doi":"10.1177/02729890222062937","DOIUrl":"https://doi.org/10.1177/02729890222062937","url":null,"abstract":"This article analyzes preferences for risk reductions in the context of individual and societal decision making. The effect of information on baseline risk is analyzed in both contexts. The results indicate that if individuals are to imagine that they suffer from 1 low-risk and 1 high-risk ailment, and are offered a specified identical absolute risk reduction, a majority will ceteris paribus opt for treatment of the low-risk ailment. A different preference structure is elicited when priority questions are framed as social choices. Here, a majority will prefer to treat the high-risk group of patients. The preference reversal demonstrates the extent to which baseline risk information can influence preferences in different choice settings. It is argued that presentation of baseline risk information may induce framing effects that lead to nonoptimal resource allocations. A solution to this problem may be to not present group-specific baseline risk information when eliciting preferences.","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"77 1","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82853586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of congruence in the ratings of patients' health status by patients and their physicians.","authors":"M. Suarez‐Almazor, B. Conner-Spady, C. Kendall, A. Russell, K. Skeith","doi":"10.1177/02729890122062361","DOIUrl":"https://doi.org/10.1177/02729890122062361","url":null,"abstract":"PURPOSE The purpose of this study was to examine if physician assessments of their patients' health status after the medical encounter are comparable to their patients' self-assessment of their own health. METHODS Consecutive patients with musculoskeletal diseases were recruited when they attended 1 of the rheumatology outpatient clinics selected for the study. Five physicians participated in the study, 4 based at an academic center and 1 in the community. Patients were interviewed after seeing the physician; they completed health status questionnaires (mHAQ and SF-12) and rated their pain, worry about disease, and overall health status on visual analog scales. Standard gamble techniques were used to obtain patient utilities in relation to their health status, \"gambling\" on the probability of obtaining perfect health from an intervention with varying risks of death. After the medical encounter, physicians were asked to rate their patients' health status with similar instruments and with standard gamble elicitation techniques, blinded to the patients' responses. RESULTS A total of 105 patients participated in the study; 70% were female; mean age was 54+/-16 years; 64% had a connective tissue disease, most commonly rheumatoid arthritis; and the other diseases in this group included soft tissue rheumatism, osteoarthritis, or low back pain. Statistically significant differences were observed between patient and physician ratings for pain, overall health, and standard gamble. On average, physicians rated their patients' health status higher than the patients themselves and were less willing to gamble on the risk of death versus perfect health. Intraclass correlation coefficients (ICC) were low: 0.42 for pain, 0.11 for worry, 0.11 for overall health, and 0.04 for standard gamble utilities. Similar findings were observed when subgroup analysis was performed for individual physicians and for patients with connective tissue diseases. No specific patient characteristic consistently related to increased divergence in the ratings. CONCLUSIONS These findings suggest that the communication between physicians and their patients at the time of the medical encounter needs to be enhanced. An understanding of their patients' health perceptions may assist physicians in suggesting appropriate interventions, taking into account their patients' benefit-risk preferences.","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"50 4 1","pages":"113-21"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89207394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of risk and benefit perception in informed consent for surgery.","authors":"A. Lloyd, P. Hayes, Paul R. Bell, A. Naylor","doi":"10.1177/02729890122062398","DOIUrl":"https://doi.org/10.1177/02729890122062398","url":null,"abstract":"BACKGROUND Informed consent relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. METHOD Seventy-one patients on the waiting list for carotid endarterectomy (CEA) were surveyed regarding their understanding and recall of the risk and benefit to health of undergoing CEA. Patients were surveyed 1 month after their initial consultation, and a subgroup was surveyed again on the day before their operation. RESULTS Patients' estimates of their baseline risk of stroke without surgery were significantly different from what they had been told by the surgeon. Patients' estimates of stroke risk due to surgery ranged from 0% to 65% (actual local risk 2%). Patients also had unreasonable expectations about the benefit of the operation for their health. Estimates of stroke risk correlated positively with the degree of expected benefit from the operation (r = 0.29, P = 0.05). When resurveyed the day before the operation, patients' perceptions of both risk and benefit had increased significantly. The risk perception data from some patients appeared to contradict some of the predictions of the fuzzy-trace theory. CONCLUSIONS Most patients failed to understand the risks and benefits associated with CEA. Some patients' estimates of stroke risk were actually greater than the perceived potential benefit of surgery in terms of risk reduction. The data also suggested a positive correlation between the degree of perceived benefit and the degree of perceived risk.","PeriodicalId":63524,"journal":{"name":"决策导刊","volume":"34 1","pages":"141-9"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77885480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}