综合评价中两种指标权重的确定方法——相似权法和属性AHM赋权法

综合评价是对多个指标进行总的评价。如果指标的权重不合理,那么,再好的评价方法也失去意义。目前关于指标权重的确定方法很多,但不外乎客观赋权法和主观赋权法两大类。本文以属性综合评价为主线,阐述两种实用的赋权方法。即基于客观赋权法的相似权法和基于主观赋权法的AHM赋权     

大学生综合素质测评方法研究现状及思考

对国内近10年的大学生综合素质的测评方法进行了综合和简要的分析评价,并对其研究进展提出了自己的见解。     

多属性效用理论在效果评价中的应用

目的将多属性效用理论引入药物经济学评价,以期进一步完善效果评价方法,提高我国药物经济学评价水平。方法分析当前我国药物经济学评价效果中的种种问题,借鉴多属性效用理论在其他方面的应用,结合效果评价的一般方法,将其用于效果评价。结果与结论多属性效用理论的应用科学合理的将效果评价的多个指标一元化,有助于效果的综合评价。     

小儿呼吸道合胞病毒性肺炎中西医对照临床疗效多属性综合评价

目的：评价小儿呼吸道合胞病毒性肺炎痰热闭肺证型中西医对照临床疗效的优劣。方法：选用成本-效果比、不良反应率、住院时间和远期疗效4个属性作为综合疗效的指标,运用TOPSIS法进行疗效评价,通过分析权重系数和属性值的动态范围以确定评价结果的稳定度。结果：中药和西药治疗方案与理想方案的相对接近程度分别为0.967和0.033,中药治疗方案更理想,权重系数和各属性的动态范围较大,评价结果稳定。结论：中药治疗方案的综合疗效优于西药治疗方案,用中药方案治疗小儿呼吸道合胞病毒性肺炎痰热闭肺证型值得向社会推广。     

达格列净应用合理性评价

目的 建立达格列净临床应用合理性评价标准,采用属性层次模型法综合评价达格列净临床应用的合理性。方法以达格列净说明书、中华医学会等发布的相关指南或专家共识为依据,制定达格列净药物利用评价标准。采用属性层次模型对2021年1—9月亳州市人民医院268例应用达格列净的归档病例进行分析评价。结果 达格列净应用主要不合理问题及占比为给药方式(91.0%)、用法用量(69.4%)、用药前评估(60.4%)、用药监护(53.7%)。达格列净应用的合理性评价结果：优秀[90≤病例分值(medicalrecordscore,MRS)<100]16例(6.0%),良好(70≤MRS<90)137例(51.1%),合格(60≤MRS<70)94例(35.1%),不合格(MRS<60)21例(7.8%)。结论 基于属性层次模型的药物利用评价操作简单,结果准确、可信,该方法将评价的多个指标整合,使评价结果更具有直观性,可在药物临床应用评价中推广。     

大学生综合素质测评工作的改进

综合素质测评工作是学生工作的一个部分，对推进大学生素质教育起着重要的作用。改进综合素质测评工作，不仅要明确完善测评方案的指导原则，以不断完善测评方案；而且要改进测评工作的各个环节，才能公平、公开、公正地做好测评工作，更好地发挥其促进素质教育的作用。     

属性层次模型在帕洛诺司琼药物利用评价中的应用

目的 建立帕洛诺司琼药物利用评价标准,综合评价帕洛诺司琼的临床应用情况。方法 以药品说明书、相关指南和专家共识为依据,建立帕洛诺司琼药物利用评价标准。采用回顾性研究方法,基于属性层次模型法对医院2020年1-6月150例使用帕洛诺司琼的病例进行合理性评价。结果 医院帕洛诺司琼临床应用不合理问题严重,主要问题为超适应证用药、用法用量不适宜、疗程过长和联合用药不合理。病例得分（MRS）≥90分的7例（4.67%）,80≤MRS <90的9例（6.00%）,60≤MRS <80的35例（23.33%）,MRS <60的99例（66.00%）。结论 属性层次模型法运用于多指标的药物利用评价具有可行性,可计算出每份病例的具体分值,分值越高合理性越好,更直观地展现病例合理性程度。医院帕洛诺司琼临床应用存在不规范,需加强管理与监督,以促进合理用药。     

基于属性层次模型的罗沙替丁醋酸酯药物合理性评价

目的 建立罗沙替丁醋酸酯(RXTA)合理性评价标准,并采用属性层次模型(AHM)综合评价罗沙替丁醋酸酯临床应用的合理性.方法 以罗沙替丁醋酸酯说明书、中华医学会、美国国立综合癌症网络等发布的相关指南和专家共识为依据,制定罗沙替丁醋酸酯合理性评价标准.采用回顾性研究方法对2020年1-6月260例应用罗沙替丁醋酸酯的归档...     

TOPSIS属性分层法在红花黄色素注射液评价的适用性评估

目的：利用加权逼近理想值排序法（TOPSIS）对红花黄注射液进行属性分层的药物评价，并将点评结果与常规药物利用评价方法（DUE）进行比较，评估该法的适用性。方法：结合DUE法建立评价标准，采用属性层次模型（AHM）加权法计算各指标的相对权重，运用TOPSIS的数据处理方法无量纲化和归一化计算各病历医嘱与完全合理医嘱的距离，直接将指标和医嘱量化，按患者诊断和年龄进行分层评价及排序，并与常规DUE评价结果进行比较，以评估运用TOPSISI分层法进行用药评价的适用性。结果：运用TOPSIS属性分层法，300份病历C_i=0.821 8，其中完全合理的病历占55.67%（C_i=1），合理病历占1.67%（1 > C_i > 0.8），基本合理病历占21%（0.8 > C_i > 0.6），不合理病历占21.67%（C_i<0.6）。TOPSIS C_i法和DUE法相比，合理性趋势相同，均能计算合理率，但TOPSIS法还能根据指标权重的不同，直接将指标和结果量化归一，结果精密度和区分度更高，具有可比性，评价深度更高，更加客观、全面。结论：经过近一年的辅助用药点评后，该院红花黄色素注射液应用基本合理，但仍存在很多问题。与常规DUE法相比，TOPSIS法在一定程度上消减了主观随意性，计算结果精密度、区分度和评价深度更高，运用TOPSIS属性分层法对红花黄色素注射液进行评价是合理可行的。     

多模式干预对帕瑞昔布临床应用合理性的影响

目的 探讨处方前置审核、药学干预和行政干预组成的多模式干预对帕瑞昔布临床应用合理性的影响.方法 根据建立的帕瑞昔布药物利用评价(DUE)标准进行回顾性研究,采用属性层次模型(AHM)法对干预前随机抽取的200例帕瑞昔布归档病例的合理性进行评价.对不合理问题采取多模式干预,采用AHM法对干预后随机抽取的200例帕瑞昔布归...     

一种基于三角模糊数的模糊多属性群决策方法

针对现实生活中常见的模糊群决策问题,基于三角模糊数的相关理论,构建了群决策的可供参照的一个模型,并通过实例说明了其有效性与可行性。     

卫生综合评价中时序资料的分析

目的:针对时序资料特点,选择合理的统计方法进行卫生综合评价,为卫生管理决策工作提供科学依据。方法:采用有时序多指标决策的灰色关联分析法,对妇幼卫生保健项目实施效果进行卫生综合评价。结果:有时序多指标决策综合评价结果显示,多层次关联度值B市最高(0.700),C省位居第二,A省最低。结论:有时序多指标决策的灰色关联分析法能够充分利用时序资料的特点,使评价更具科学性和合理性。     

Serotonin transporter gene-linked polymorphic region (5-HTTLPR) influences decision making under ambiguity and risk in a large Chinese sample

Risky decision making is a complex process that involves weighing the probabilities of alternative options that can be desirable, undesirable, or neutral. Individuals vary greatly in how they make decisions either under ambiguity and/or under risk. Such individual differences may have genetic bases. Based on previous studies on the genetic basis of decision making, two decision making tasks [i.e., the Iowa Gambling Task (IGT) and Loss Aversion Task (LAT)] were used to test the effect of 5-HTTLPR polymorphism on decision making under ambiguity and under risk in a large Han Chinese sample (572 college students, 312 females). Basic intelligence and memory tests were also included to control for the influence of basic cognitive abilities on decision making. We found that 5-HTTLPR polymorphism significantly influenced performance in both IGT and LAT. After controlling for intelligence and memory abilities, subjects homozygous for s allele had lower IGT scores than l carriers in the first 40 trials of the IGT task. They also exhibited higher loss aversion than l carriers in the LAT task. Moreover, the effects of 5-HTTLPR were stronger for males than for females. These results extend the literature on the important role of emotion in decision making under ambiguity and risk, and shed additional lights on how decision making is influenced by culture as well as sex differences. Combining our results with existing literature, we propose that these effects might be mediated by a neural circuitry that comprises the amygdala, ventromedial prefrontal cortex, and insular cortex. Understanding the genetic factors affecting decision making in healthy subjects may allow us to better identify at-risk individuals, and better target the development of new potential treatments for specific disorders such as schizophrenia, addiction, and depression.     

Influence of BDNF and COMT polymorphisms on emotional decision making

Decision making is an important brain function. Although little is known about the genetic basis of decision making, it has been suggested that it is mediated by the modulation of neurotransmitter systems. We investigated how the BDNF Val66Met and COMT Val158Met polymorphisms affect emotional decision making using the Iowa Gambling Task (IGT). One hundred sixty-eight healthy Korean college students (93 males, 75 females) with a complete dataset were included in the data analysis. The IGT and genotyping for the polymorphisms of BDNF Val66Met and COMT Val158Met were performed. Both Met/Met and Val/Met of the BDNF Val66Met polymorphism were significantly associated with a lower mean score of blocks 3-5 of the IGT and with less improvement from block 1 to block 3-5 than the Val/Val. However, the BDNF was not significantly associated with the score of block 1, and the COMT Val158Met polymorphism produced no significant effect on IGT performance. No interaction effect was observed between the BDNF and the COMT for the IGT. These findings suggest the BDNF Val66Met may affect the emotional decision making performance.     

综合评价方法在药学研究中的应用

对多属性体系结构描述的对象系统做出全局性、整体性的评价是科学研究的关键点之一。综合评价方法是运用多指标多总体同时进行定量评价和比较的一种方法。本文简要介绍了应用于药学研究的4类综合评价方法(统计分析方法、系统工程法、模糊数学法和智能化方法)中几种常用方法的优缺点及应用实例。     

Reduced Dopamine Transporter Functioning Induces High-Reward Risk-Preference Consistent with Bipolar Disorder

Individuals with bipolar disorder (BD) exhibit deleterious decision making, negatively impacting their lives. Such aberrant decision making can be quantified using the Iowa Gambling Task (IGT), which requires choosing between advantageous and disadvantageous options based on different reward/punishment schedules. The mechanisms underlying this behavioral deficit are unknown, but may include the reduced dopamine transporter (DAT) functioning reported in BD patients. Using both human and mouse IGTs, we tested whether reduced DAT functioning would recreate patterns of deficient decision making of BD patients. We assessed the IGT performance of 16 BD subjects (7 female) and 17 healthy control (HC) subjects (12 female). We recorded standard IGT performance measures and novel post-reward and post-punishment decision-making strategies. We characterized a novel single-session mouse IGT using C57BL/6J mice (n=44). The BD and HC IGT performances were compared with the effects of chronic (genetic knockdown (KD; n=31) and wild-type (n=28) mice) and acute (C57BL/6J mice (n=89) treated with the DAT inhibitor GBR12909) reductions of DAT functioning in mice performing this novel IGT. BD patients exhibited impaired decision making compared with HC subjects. Both the good-performing DAT KD and GBR12909-treated mice exhibited poor decision making in the mouse IGT. The deficit of each population was driven by high-reward sensitivity. The single-session mouse IGT measures dynamic risk-based decision making similar to humans. Chronic and acute reductions of DAT functioning in mice impaired decision-making consistent with poor IGT performance of BD patients. Hyperdopaminergia caused by reduced DAT may impact poor decision making in BD patients, which should be confirmed in future studies.     

A qualitative analysis of emerging adult black men’s sexual decision-making behavior and substance use

Emerging adult Black men and substance users may have an increased risk for compromised sexual health. This study qualitatively investigated how substance use affects the sexual decision-making of emerging adult Black men. Nineteen Black men in college (18–24 years) completed a semi-structured interview about their sexual attitudes, behaviors, and perceptions and their substance use. Results show that substance use may not independently affect sexual risk behavior among emerging adult Black men. Findings highlight the importance of using approaches that incorporate structural and sociocultural factors when framing research and interventions related to substance use, sexual decision making, and Black men.     

Acute effects of alcohol on social and personal decision making

Social drinking is common, but it is unclear how moderate levels of alcohol influence decision making. Most prior studies have focused on adverse long-term effects on cognitive and executive function in people with alcohol use disorders (AUD). Some studies have investigated the acute effects of alcohol on decision making in healthy people, but have predominantly used small samples and focused on a narrow selection of tasks related to personal decision making, e.g., delay or probability discounting. Here, we conducted a large (n = 264), preregistered randomized placebo-controlled study (RCT) using a parallel group design, to systematically assess the acute effects of alcohol on measures of decision making in both personal and social domains. We found a robust effect of a 0.6 g/kg dose of alcohol on both moral judgment and altruistic behavior, but no effects on several measures of risk taking or waiting impulsivity. These findings suggest that alcohol at low to moderate doses selectively moderates decision making in the social domain, and promotes utilitarian decisions over those dictated by rule-based ethical principles (deontological). This is consistent with existing theory that emphasizes the dual roles of shortsighted information processing and salient social cues in shaping decisions made under the influence of alcohol. A better understanding of these effects is important to understand altered social functioning during alcohol intoxication.Subject terms: Risk factors, Human behaviour     

Measuring health preferences for use in cost-utility and cost-benefit analyses of interventions in children: theoretical and methodological considerations

Valuing the health of children for cost-utility or cost-benefit analysis poses a number of additional challenges when compared with valuing adult health. Some of these challenges relate to the inability of young children to value changes in health directly and the potential biases associated with using proxy respondents. Other challenges arise from children not being able to perform as independent economic actors, but dependent on others for care and decision making. In addition, illness in children may affect parent/caregiver quality of life, further complicating the measurement of value associated with a change in a child's health status. We review the most common approaches (QALYs and willingness-to-pay values) for valuing health in economic evaluations and consider the methodological and practical issues associated with measuring child health using each framework. Recommendations for advancing the field of valuing child health for economic evaluations will vary by age; a 'one size fits all' approach does not readily fit. Although limitations exist for all of the methods considered for valuing child health, the currently recommended approach for infants and preschoolers is direct valuation by a proxy respondent. For school-age children and adolescents, existing multi-attribute instruments can be applied in some situations but direct valuation may be required for others. Future research should focus on minimising bias from proxy respondents, consideration of a family- or household-based approach to valuing health effects, and development of generic instruments with domains that are appropriate to children and that vary with age.     

Radiolabelled peptides and monoclonal antibodies for therapy decision making in inflammatory diseases

Radiolabelled peptides and monoclonal antibodies are an emerging class of radiopharmaceuticals for imaging inflammation with clinical implications for several chronic inflammatory disorders for diagnosis, therapy decision making and follow up. In the last decades, a number of novel monoclonal antibodies and peptides have been introduced for the treatment of different inflammatory disorders and also labelled with a variety of radionuclides depending upon the specific applications, diagnostic or therapeutic, by using direct or indirect methods. These radiopharmaceuticals bind to their targets with high affinity and specificity and therefore have an excellent diagnostic potential for the imaging of patients with chronic inflammatory diseases. In this review article we describe the characteristics of peptides, cytokines and monoclonal antibodies with a particular emphasis on their role in therapy decision making and follow up in different inflammatory diseases.