Medical decision making should be idividual considering and incorporating not only effect estimates but also all possible attributes of the person, clinical states, circumstances, values and preferences.
主な文献: Alonso-Coello P, Oxman AD, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Vandvik PO, Meerpohl J, Guyatt GH, Schünemann HJ, GRADE Working Group: GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ 2016;353:i2089. doi: 10.1136/bmj.i2089 PMID: 27365494
Alonso-Coello P, Schünemann HJ, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Rada G, Rosenbaum S, Morelli A, Guyatt GH, Oxman AD, GRADE Working Group: GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ 2016;353:i2016. doi: 10.1136/bmj.i2016 PMID: 27353417
Moberg J, Alonso-Coello P, Oxman AD. GRADE Evidence to Decision (EtD) Frameworks Guidance. Version 1.1 [updated May 2015], The GRADE Working Group, 2015. Available from: https://ietd.epistemonikos.org/#/help/guidance
・FDAのStructured Benefit-Risk Framework: 医薬品評価における透明性と一貫性の確保 PDF
・FDAのStructured Benefit-Risk Frameworkと患者選好情報 (PPI) PDF
用語を確認しておきましょう:
Importance of outcome アウトカムの重要性/重要度、Values価値観、Preferences選好の関係は以下の様に表現されると思います。GRADE Working Groupはアウトカムの重要度と患者の価値観は同じことを意味しており、文脈により使い分けると述べています。
文献: Ho M, Saha A, McCleary KK, Levitan B, Christopher S, Zandlo K, Braithwaite RS, Hauber AB: A Framework for Incorporating Patient Preferences Regarding Benefits and Risks into Regulatory Assessment of Medical Technologies. Value Health. 2016;19:746-750. doi: 10.1016/j.jval.2016.02.019 doi: 10.1016/j.jval.2016.02.019 PMID: 27712701
•Boyd CM, Singh S, Varadhan R, Weiss CO, Sharma R, Bass EB, Puhan MA. Methods for Benefit and Harm Assessment in Systematic Reviews. Methods Research Report. (Prepared by the Johns Hopkins University Evidence-based Practice Center under contract No. 290-2007-10061-I). AHRQ Publication No. 12(13)-EHC150-EF. Rockville, MD: Agency for Healthcare Research and Quality; November 2012. Link
Alper BS, Oettgen P, Kunnamo I, Iorio A, Ansari MT, Murad MH, Meerpohl JJ, Qaseem A, Hultcrantz M, Schünemann HJ, Guyatt G, GRADE Working Group: Defining certainty of net benefit: a GRADE concept paper. BMJ Open 2019;9:e027445. PMID: 31167868