论文部分内容阅读
尽管已有对勃起功能障碍(ED)治疗效果评价的方法和标准,但是却没有对评价更广泛的疗效或界定ED治疗失败的指导要领。一个代表多数人意见的国际专家顾问小组开会确定了对评估ED治疗效果的指导要领、阐述和新的规则系统。专家们推荐将这些新的指导要领应用于科研和临床。一个由11位多学科的高级研究者和临床医师组成的专家组开会重点讨论了和ED治疗结果评估有关的问题。该小组使用了普遍应用的经改进的德菲法,并提出了一个新的疗效评估模型。运用现有的设备和评估方法,这个模型自然是可测试的。经过对广泛文献的阅览与讨论后,该小组推荐采用一个新的治疗效果的概念框架或理论模型来评估治疗ED的效果。治疗效果被认定为由另两方面因素的联合作用组成,即治疗反应和治疗满意度。治疗反应是以对效能和耐受性的综合评估为基础,而治疗满意度则是以患者和其性伴侣满意程度的综合评估为基础。这两项主要指标合在一起显示出治疗效果的整体指标。这个“疗效指标”可通过病例记录、问卷调查或与较典型患者的交谈等方法对治疗效能和满意度进行独立评估而获得。总之,该特别顾问专家小组推荐采用一个新的框架或概念模型来指导ED的疗效试验或临床研究。“治疗效果”这一概念的提出是作为一种新的“伞式概念”或需要评价的远期疗效。
Despite the existence of methods and criteria for evaluating the efficacy of treatment of erectile dysfunction (ED), there is no guideline for evaluating a broader efficacy or defining the failure of ED treatment. A panel of international experts representing the opinions of the majority met to determine the guidelines, explanations and a new rules system for assessing the effects of ED treatment. Experts recommend these new guidelines for research and clinical applications. A panel of 11 multidisciplinary senior researchers and clinicians met to focus on issues related to the evaluation of ED outcomes. The team used the commonly used improved Defective method and proposed a new model of efficacy evaluation. With existing equipment and assessment methods, this model is naturally testable. After reading and discussing extensive literature, the group recommended using a new conceptual framework of treatment effects or theoretical models to assess the efficacy of treatment of ED. Therapeutic effect was identified as a combination of two other factors, namely, response to treatment and satisfaction with treatment. Treatment response is based on a comprehensive assessment of efficacy and tolerability, and treatment satisfaction is based on a comprehensive assessment of patient and sexual partner satisfaction. Together, these two key indicators show an overall measure of the effect of treatment. This “measure of efficacy” can be obtained by independently assessing treatment efficacy and satisfaction by means of case history, questionnaires, or conversations with more typical patients. In conclusion, the panel of ad hoc advisers recommended a new framework or conceptual model to guide the curative or clinical study of ED. The concept of “therapeutic effect” is proposed as a new “umbrella concept” or as long-term efficacy that needs evaluation.