宫内节育器综合评价指标体系研究

目的:建立宫内节育器(IUD)综合评价指标体系,为临床应用及政府采购、推广和新产品研发提供理论依据。方法:借鉴卫生服务三环节评价理论和产品评价理论构建指标体系框架,经多次专家讨论确定初始指标体系,结合临床随访资料,利用相关系数法、变异系数法和因子分析法筛选指标,运用主成分分析结合专家意见法计算指标的权重,用TOPSIS法、综合指数法、秩和比法和模糊数学法对元宫Cu300 IUD、TCu380A IUD和活性165 IUD进行综合评价。结果:①构建出由服务提供、产品性能、经济性3个一级指标,服务过程、随访、产品有效性、副反应、并发症、可接受性6个二级指标,放置不顺利率、带器妊娠率、并发症率和避孕效果满意率等16个三级指标组成的IUD综合评价指标体系。②TOPSIS法、综合指数法和模糊数学法对3种IUD的综合评价结果为:元宫Cu300 IUD排名第一,TCu380A IUD第二,活性165 IUD第三。秩和比法的排序为:元宫Cu300 IUD第一,活性165 IUD第二,TCu380A IUD第三。结论:指标体系的构建由理论基础、专家的丰富经验以及大样本临床随访资料做支撑,采用主客观相结合的方法筛选指标,构建过程科学、严谨。利用指标体系评价3种IUD的结果具有一致性,与临床经验相符,说明具有现实可行性和可操作性。

Study on the Synthetical Evaluation Pattern of Intrauterine Device

Objective： To establish a synthetical evaluation index system based on the theory of health service and theory product evaluation.The result of evaluation was useful for the contraception produces＇ government procurement,promotion and product research.Methods： Firstly,based on the theory of three links of health service and theory of product evaluation,the primary index system of synthetical evaluation was established.Secondly,the indexes were based filtered out on the expert advices and using Correlation Coefficient Analysis,Variation Coefficient Analysis and Factors Analysis.Thirdly,each index was given weight using Principal Components Analysis and basing on the advices of experts.Fourthly,3 kinds of intrauterine device（IUD） which were Yuangong IUD,TCu380A IUD and 165 IUDwere evaluated synthetically by the methods of TOPSIS,synthetical index on the basis of weight,rank-sum ratio and fuzzy mathematics.Results： The whole index system had three-stage,3 indexes among first class,6 indexes for second class,and 16 indexes for tertiary class.The first class included service,product function and economy.The second class was service process,followed up,effectiveness,side effect,complication and acceptability.The tertiary class included 16 indexes--ratio of operation successful,cervical dilatation,and so on.The results of TOPSIS,synthetical index on the basis of weight and fuzzy mathematics were that the ranked first was Yuangong IUD,the ranked second was TCu380A IUD,and the ranked third was 165 IUD.The result of rank-sum ratio was that ranked first was Yuangong IUD,the ranked second was 165 IUD,and the ranked third was TCu380A IUD.Conclusion： The index system was based on theories,experience of experts and follow-up information.Filtering index used the subjective and objective method.The results of different synthetical evaluations were consistent.The synthetical evaluation pattern was reliable.