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目的:为建立完善的抗菌药物使用合理性评价指标体系提供科学依据。方法:在文献调研的基础上,运用Delphi法对30名相关领域专家采用 E-mail 和现场发放调查问卷2种方式进行专家咨询,以专家咨询问卷的有效回收率表示专家积极系数,以权威系数表示专家权威程度,以指标重要性赋值及满分比反映专家意见的集中程度,以变异系数和协调系数表示专家意见的协调程度,经多轮函询后,确定抗菌药物合理性评价指标体系。结果与结论:共经过两轮函询。两轮调查的问卷回收率分别为100%和96.67%,表明专家积极性较高;权威系数为0.91和0.88,表明专家权威程度较高。最终建立了包含4个一级指标(适应证、药物选择、用药过程、管理指标)以及下设的35个二级指标的抗菌药物合理性评价指标体系,其中一级指标重要性评分均数为4.28~5.00,满分比为0.93~1.00,变异系数为0.00~0.15,协调系数为0.446(P<0.001);二级指标的重要性评分均数为3.83~4.79,满分比为0.67~1.00,变异系数为0.10~0.26,协调系数为0.115(P<0.001),表明本体系较为可靠。
OBJECTIVE: To provide scientific evidence for establishing perfect rationality evaluation indicator system of antibiotics. METHODS: On the basis of literature research, Delphi method was used to conduct several rounds of consultations on 30 experts in related fields with E-mail and questionnaire field investigation. After several rounds of consultations, rationality evaluation index system for antibiotics was determined. The effective recovery rate of expert consultation questionnaire was used to express the positive coefficient of experts; the authoritative coefficient was used to express the authoritative degree of experts; the index importance assignment and the full score ratio were used to reflect the concentration degree of experts’ opinions; the coefficient of variation and the coefficient of coordination were used to express the coordination degree of experts’ opinions. RESULTS & CONCLUSIONS: After two rounds of consultations, response rates of the questionnaire in two rounds of surveys were 100% and 96.67%, indicating experts were highly motivated. The authoritative coefficients were 0.91 and 0.88, indicating experts had a high degree of authority. Finally, an evaluation index system for rationality of antibiotics was established, which included four first-level indicators (indications, drug selection, medication process, management indicators) and 35 second-level indicators. Among them, the mean value of importance scoring of first-level indicators ranged from 4.28 to 5.00, the full score ratio from 0.93 to 1.00, the coefficient of variation from 0.00 to 0.15 and the coefficient of coordination was 0.446 (P<0.001). While, the mean value of importance scoring of second-level indicators ranged from 3.83 to 4.79; the full score ratio from 0.67 to 1.00; variation coefficient from 0.10 to 0.26 and the coefficient of coordination was 0.115 (P<0.001), which indicating the system was reliable.
Delphi法抗菌药物合理性评价指标体系
Delphi methodAntibioticsRationality evaluationIndicator system
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