Dear Sanguansak
Date sent: Mon, 17 Jul 2000 08:56:28 -0700 (GMT)
Subject: How to make or write a relative value in cpg
From: sanguansak thanaviratananich <<[log in to unmask]>
To:
Send reply to: sanguansak thanaviratananich <<[log in to unmask]>
7F00,0000,0000>
> I and our colleagues are writing a national guideline for allergic
> rhinitis. We have some questions to ask
> 1. How can we make a relative value judgement of different options in
> the CPG acccoding to the viewpoints of doctors, patients, society in a
> sensible way?.
Well, value judgements can only be reported if they are elicited, so
you need some primary research on treatment preferences for
allergic rhinitis. Worth searching for briefly, but I doubt there is
much out there (the only field where I know it has been done is
oncology). Mind you, when someone makes a statement like this
in this forum, there is usually a flood of messages showing how
ignorant they are...
7F00,0000,0000> 2.Where can I find a useful document as a guide for making a value
> judgement?
There is no guide for allocating treatment preferences independent
of condition and relevant stakeholders. Decision analysis is a
method of deriving individual preferences for treatment. David Eddy
and Jack Dowie have written extensively on this, but I don't think
their work solves your problem.
One ad hoc approach for a guidelines project is to make sure that
you have different docs (ie. specialists, generalists) and patients on
your group in an attempt to balance different clinical and societal
perspectives. It is possible to make some of these judgements
explicit: eg. "nasal steroid are more clinically effective than anti-
histamines, but the panel thought that the latter are more
convenient to use". Alternatively you could list the pros and cons of
different treatment options and let the reader and their patient
decide!
Good luck.
Gene Feder
Department of General Practice and Primary Care
St Bartholomew's and Royal London Hospital Medical and Dental School
Queen Mary and Westfield College
Mile End Road
London E1 4NS
020 7882 7957 (tel)
020 7882 7911 (fax)
01426 632 748 (pager)
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