Construction of clinical comprehensive evaluation index system for sodium-glucose cotransporter 2 inhibitor of type 2 diabetes mellitus based on delphi method and analytic hierarchy process
Objective To construct a clinical comprehensive evaluation index system for sodium-glucose cotransporter 2(SGLT-2)inhibitors in the clinical management of type 2 diabetes mellitus(T2DM),to provide methodological references for the rational use of drugs in clinical practice.Methods Preliminary indicators were established based on literature research and expert consultations,and the final index system and weightings were determined through two rounds of the Delphi method and analytic hierarchy process.Results After expert consultations and discussions,the final clinical evaluation index system for SGLT-2 inhibitors in the treatment of T2DM was determined,which included 6 first-level indicators and 32 second-level indi-cators.The weights of the first-level indicators were as follows:efficacy(25.42%),safety(23.50%),economy(15.87%),suitability(12.21%),innovation(11.79%),and accessibility(11.21%).The combined weights of the second-level indica-tors ranged from 1.43%to 5.52%,cost-utility analysis(5.52%)and average annual treatment cost(5.42%)ranked the top two,followed by the second-level indicators of efficacy,such as the rate of HbA1c compliance(5.41%),the reduction of HbA1c level(5.41%)and the reduced risk of all-cause mortality(5.27%).The weight of the safety indicators related to ad-verse reactions was relatively large and medication adherence and availability were the top second-level indicators of suitabili-ty and accessibility.Conclusion SGLT-2 inhibitor clinical comprehensive evaluation index system in the treatment of T2DM has been constructed based on the Delphi method and analytic hierarchy process in this study,which possesses high authority,scientific and reliability,and provides methodological references for comprehensive analysis decision-making.Because of the differences in the properties of different medicines,disease characteristics,and populations,it is necessary to carry out a compre-hensive clinical evaluation that is more in line with the current drug needs based on this.
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