The multi-attribute utility function (MAUF) is a commonly used method for measuring health utility, characterized by a solid theoretical foundation and operational feasibility. It contributes to reducing the cognitive burden on respondents, caters to the measurement of utility across multiple dimensions, and represents another most widely applied approach beyond traditional econometrics, warranting exploration and application. However, there is currently a lack of comprehensive and systematic research on this method in China, with insufficient practical application experience. Against this backdrop, this paper aims to systematically explore the methodological background of MAUF and the key points of research design for measuring health utility using this method. By drawing on the utility measurement experiences from internationally developed measurement scales such as HUI 1, HUI 2, HUI 3, 15D, AQol-8D, ASUI, HUG-5, TOOL, and ALSUI, it systematically analyzes the critical steps in the practical implementation of the method. It is hoped that this work will comprehensively and clearly elaborate on the practical approaches of MAUF, promote the further development of MAUF in China, and provide methodological references for future studies on health utility measurement based on MAUF.
Patient-reported outcome measures (PROM) measure attribute studies refer to studies conducted by investigators to validate the measurement attributes of PROM. The consensus-based standards for the selection of health measurement instruments (COSMIN), an international consensus standard for the selection of health measurement instruments, divides this attribute into three aspects: reliability, validity and responsiveness, and adds interpretability as an additional important feature for evaluating PROM. The purpose of this paper is to introduce the verification methods and principles of the three major measurement attributes in the COSMIN consensus, as well as the significance and direction of interpretability evaluation, and to provide international methodological experience and reference for the development of high-quality PROM psychometric attribute verification in China.
ObjectiveTo systematically review the medication adherence of patients with hypertension treated with single-pill combinations (SPC) compared with free combination therapy (FEC). MethodsThe PubMed, Embase, Cochrane Library, Web of Science, CBM, WanFang Data, and CNKI databases were electronically searched to collect cohort studies and randomized controlled trials (RCTs) related to the objectives from inception to March 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using R 4.3.3 software. ResultsA total of 21 studies were included, comprising 4 RCTs and 17 cohort studies, involving 461 030 patients. Meta-analysis showed that SPC therapy significantly improved medication adherence compared with FEC in terms of proportion of days covered (PDC) (OR=2.53, 95%CI 1.67 to 3.82, P<0.01) and medication possession ratio (MPR) (OR=2.05, 95%CI 1.23 to 3.42, P=0.02), with statistically significant differences. However, there was no statistically significant difference in blood pressure reduction between SPC and FEC for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P>0.05). ConclusionCurrent evidence shows that SPC can improve medication adherence in patients with hypertension. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo compare the safety and efficacy of powered anastomosis versus mechanical anastomosis in gastrointestinal surgery. MethodsComputerized searches were conducted in PubMed, EMbase, Web of Science, CNKI, and CBM databases to collect studies comparing the safety and efficacy of powered versus mechanical anastomosis in gastrointestinal surgery. The search period was from the inception of each database to March 2025. Literature was screened according to inclusion and exclusion criteria, data were extracted, and the risk of bias was assessed. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using the Metan package in Stata/MP 17.0 software. ResultsA total of 15 observational studies (13 retrospective and 2 prospective) involving 21,424 patients were finally included, with 9 823 patients in the experimental group (powered anastomosis) and 11 601 patients in the control group (mechanical anastomosis). The NOS scores of all included studies were ≥5 points. Meta-analysis results showed that, compared to the mechanical anastomosis group, the powered anastomosis group had significantly lower incidence rates of anastomotic leakage [RR=0.60, 95%CI (0.37, 0.96), P=0.031], postoperative complications [RR=0.68, 95%CI (0.53, 0.86), P<0.01], intraoperative bleeding rate [RR=0.29, 95%CI (0.15, 0.56), P<0.01], and 30-day readmission rate [RR=0.62, 95%CI (0.39, 0.97), P<0.05]. No statistically significant differences were found in anastomotic stenosis [RR=0.53, 95%CI (0.18, 1.57), P=0.25], intraoperative blood loss [SMD=−0.03, 95%CI (−0.15, 0.08), P=0.57], operation time [SMD=−0.00, 95%CI (−0.08, 0.07), P=0.90], or postoperative hospital stay [SMD=−0.05, 95%CI (−0.13, 0.02), P=0.15]. ConclusionIn gastrointestinal surgery, powered anastomosis may offer potential advantages over traditional mechanical anastomosis in improving the aforementioned safety and efficacy outcomes.