最优治疗策略:患者视角

The Optimal Treatment Strategy—A Patient's Perspective

Management Science · 1987
被引 13
人大 A+FT50UTD24ABS 4*

中文导读

从患者角度建立模型,分析是否参与治疗及最佳时机,考虑客观医疗技术与主观偏好,适用于单病单治、多病多治等场景,常见最优解为“要么现在要么永不”。

Abstract

In this paper we present a general model that enables us to better understand the decision of a patient whether or not to participate in a treatment, and, if so, the optimal timing for the treatment, from his point of view. The model takes into account both “objective information” which represents medical technology as well as “subjective information” which represents the patient's preference. By doing so it is attuned to the school of thought that medical care is not required for its own sake but for the sake of its effect on health as perceived by the patient himself. The framework presented is used to analyze the optimal decision for the individual for several different cases: One disease-one treatment; one disease-several alternative treatments; many diseases-many treatments; direct payment vs. full insurance; and the effect of the possible future introduction of a better treatment. The optimal decision of treatment for the individual is also analyzed under different assumptions in relation to the parameters. For example, both quality of life in a state of disease and the probability of success of the treatment are constant versus the case where both decrease over time; the comparison between the use of population and individual mortality rates by individuals for decision making; and treatment affecting only quality of life vs. treatment which also affects the individual's life span. The most common decision that results from our model (especially when treatment affects only quality of life) is a bang-bang solution. That is, the optimal timing of a treatment is now or never.

患者治疗决策治疗时机主观偏好客观信息