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基于多准则决策分析评价骨科大手术后新型口服抗凝药物的综合价值
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| 篇名： | 基于多准则决策分析评价骨科大手术后新型口服抗凝药物的综合价值 |
| TITLE： | Comprehensive value of novel oral anticoagulant drugs after major orthopedic surgery based on multi-criteria decision analysis |
| 摘要： | 目的 评估骨科大手术后新型口服抗凝药物（NOACs）的综合价值。方法通过文献调研收集评估证据，引入证据与价值对决策的影响（EVIDEM）框架整合评价流程，运用多准则决策分析（MCDA）法构建多维评价体系，通过德尔菲法结合层次分析法确定各评价权重，对利伐沙班、达比加群、阿哌沙班进行综合评价。结果成功建立了骨科大手术后NOACs的临床综合评价体系，计算出骨科大手术后NOACs（利伐沙班、达比加群、阿哌沙班）各级指标的最终临床综合评价权重得分，分别为利伐沙班0.3997分、阿哌沙班0.2444分、达比加群0.3559分，即利伐沙班的临床综合价值最高。其中在单一维度中，利伐沙班在药学特性、经济性及其他属性评价方面的权重得分最高；在有效性和安全性评价方面，阿哌沙班的权重得分最高。结论在NOACs中，利伐沙班更适用于骨科大手术后的常规抗凝管理，尤其在药学特性、经济性和其他属性方面具有临床实践优势。 |
| ABSTRACT： | OBJECTIVE To evaluate the comprehensive value of novel oral anticoagulant drugs （NOACs） after major orthopedic surgery. METHODS The evaluation evidence was collected through literature research； evidence and value：impact on decision-making （EVIDEM） framework was introduced to integrate the evaluation process； the multi-criteria decision analysis （MCDA） method was used to construct a multi-dimensional evaluation system； the weights assigned to each evaluation criterion were determined by the combination of Delphi method and analytic hierarchy process， and the rivaroxaban， dabigatran and apixaban were comprehensively evaluated. RESULTS The clinical comprehensive evaluation system of NOACs after major orthopedic surgery was successfully established， and the final clinical comprehensive evaluation weights of NOACs （rivaroxaban， dabigatran， apixaban） after major orthopedic surgery were calculated， with scores of 0.399 7 for rivaroxaban， 0.244 4 for apixaban， and 0.355 9 for dabigatran， indicating that rivaroxaban demonstrated the highest overall clinical value. Among them， rivaroxaban had the highest weight score in the evaluation of pharmaceutical characteristics， cost-effectiveness and other attributes in a single dimension. In terms of efficacy and safety evaluation， apixaban had the highest weighting score. CONCLUSIONS Among NOACs， rivaroxaban is more suitable for routine anticoagulation management after major orthopedic surgery， especially in terms of pharmacological properties， cost-effectiveness and other attributes. |
| 期刊： | 2025年第36卷第13期 |
| 作者： | 刘心如；周鑫叠；杨洋；龚金红；徐姗；苏丹；商晶晶 |
| AUTHORS： | LIU Xinru，ZHOU Xindie，YANG Yang，GONG Jinhong，XU Shan，SU Dan，SHANG Jingjing |
| 关键字： | 多准则决策分析；临床综合评价；新型口服抗凝药物；骨科大手术；静脉血栓栓塞；层次分析法；德尔菲法；证据与价值对 |
| KEYWORDS： | multi-criteria decision analysis； comprehensive |
| 阅读数： | 6 次 |
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