文章针对医生、患者等对治疗方案的疗效和风险等存在不同的偏好,难以达成一致的治疗决策,提出了一种基于离散选择实验(DCE)和逼近理想解法(TOPSIS)的治疗方案选择方法。在应用离散选择实验调查患者及医生的偏好基础上,引入逼近理想解法对各种治疗方案进行定量评价。最后,以转移性肾细胞癌的靶向治疗为例说明该方法的具体应用,并比较了医生决策、患者决策、医患共同参与决策等不同决策方式下各治疗方案的评价排序,为临床决策制定提供参考意见。
Physicians and patients represent different preferences for efficacy and adverse events of treatments and it is difficult to establish mutual agreement in decision making,so a decision support system for treatment selection is proposed.Discrete Choice Experiment(DCE)is constructed to elicit preferences of patients and health care professionals. To address multiple decision criteria in treatment ranking,the technique for order preference by similarity to ideal solution(TOPSIS)is employed to select the final treatments.Finally,an application example about targeted therapy for metastatic renal cell carcinoma is given,and different priorities are analyzed of treatments for physician-only,patientonly and physician-patient shared decision-making,which will provide valuable suggestions for healthcare decision making in practice.