WWW BASED NORMATIVE PATIENT DECISION SUPPORT

基于 WWW 的规范患者决策支持

• 批准号: 6055742
• 负责人: LESLIE A. LENERT
• 金额: $ 17.57万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-30 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6055742
• 关键词: Internet; behavioral /social science research tag; clinical research; computer assisted medical decision making; computer program /software; decision making; health care model; human subject; human therapy evaluation; model design /development; outcomes research; preference; rheumatoid arthritis

As medical technology continues to advance, patients face an increasing variety of treatment choices. Further, the amount of time that physicians have to listen to patients and tailor treat-ments to patient preferences is decreasing due to changes in the way medicine is being practiced. Therefore, it is especially important to find new ways to increase both the objectivity and the degree of patient participation in treatment decisions. In this proposal we describe a three-part process to achieve these goals and disseminate the results over the World Wide Web (WWW). In the first part of our study, we will characterize patient preferences for common multi-dimensional health states in rheumatoid arthritis (RA) using Time Trade-Off and Visual Analog Scale methods. We will study patient values in 300 RA patients recruited over the WWW. We will learn about how patients value losses and gains in different dimensions of health, and whether disability and pain caused by drug toxicities deserve greater weight in decision-making than similar outcomes caused by disease progression. We will also compare patients' values for outcomes to those of a sample of rheumatologists. In the second part of our study, we will develop a decision model for evaluating different treatments for rheumatoid arthritis and integrate this model into a second computer program. This program will be able to describe health outcomes, measure preferences for those outcomes, and then generate individual specific treatment recommendations. We will validate this program by comparison of its therapeutic recommendations to those of expert rheumatologists. In the third part of this study, we will apply the program in a representative sample of rheumatoid arthritis patients to study the degree to which patients' current therapies for RA are consistent with their preferences, to assess patient reactions to the program, and to further validate the program's recommendations. When we have perfected our model and are finished with validation studies, we will make our software available over the WWW to RA patients and rheumatologists who wish to use this software for decision support. We will also distribute generalized versions of the software for use to other investigators in other disease areas via the WWW site.

随着医疗技术的不断进步，患者面临着越来越多的挑战 多种治疗选择。 此外，所花费的时间 医生必须倾听患者的意见并根据患者的情况制定治疗方案 由于医学方式的变化，偏好正在减少 练习过。 因此，寻找新的方法显得尤为重要。 提高客观性和患者参与程度 在治疗决策中。 在这个提案中，我们描述了一个由三部分组成的 实现这些目标的过程并在整个过程中传播结果 万维网（WWW）。在我们研究的第一部分，我们将 描述患者对常见多维健康的偏好 使用时间权衡和视觉来评估类风湿性关节炎 (RA) 的状态 模拟量表方法。 我们将研究 300 名 RA 患者的患者价值观 通过 WWW 招募。 我们将了解患者如何评估损失 以及在健康的不同方面取得的成果，以及残疾和残疾是否 药物毒性引起的疼痛在决策中应受到更多重视 比疾病进展引起的类似结果。 我们还将 将患者的结果值与样本的值进行比较 风湿病学家。 在我们研究的第二部分，我们将开发一个 评估类风湿不同治疗方法的决策模型 关节炎并将该模型集成到第二个计算机程序中。 这 计划将能够描述健康结果、衡量偏好 针对这些结果，然后产生个体化的具体治疗 建议。 我们将通过比较来验证该程序 向风湿病专家提供治疗建议。 在 在本研究的第三部分，我们将把该程序应用到一个有代表性的人身上 类风湿性关节炎患者样本来研究其程度 患者目前的 RA 治疗方法与他们的情况一致 偏好，评估患者对该计划的反应，并进一步 验证该计划的建议。 当我们完善了自己的 模型并完成验证研究后，我们将制作我们的 RA 患者和风湿科医生可通过 WWW 获取该软件 希望使用该软件进行决策支持。 我们还将分发 该软件的通用版本，供其他研究人员使用 通过 WWW 网站了解其他疾病领域。