Values ​​and preferences The Commission examined the issues before it in terms of values ​​and patient preferences. In anticipation of the first meeting of the commission, which included two patients who have undergone COVID-19, its members were asked to study the list of final outcomes that are considered relevant for scientific research on COVID-19.
It was asked to characterize the importance and present their own rank assessment of each final outcome on a scale of significance from “extremely significant” to “almost unimportant”. In this assessment, each panelist was asked to look at the issue from the patient’s perspective and make judgments based on the values ​​and preferences of COVID-19 patients around the world, rather than their own.
In this regard, one of the sources of information as the discussion developed was the opinions of patients who make up the commission, to whom the experts turned. In addition, the experts took into account their own decision-making experience when interacting with patients and their families. Throughout all e-mail discussions and during both sessions, the Practice Leader regularly reminded panelists that guidelines are developed in the best interest of all patients and thus should take into account the values ​​and preferences of the average patient.
With the pandemic placing a heavy burden on health systems around the world, panelists also placed particular emphasis on resource endowment (i.e. looking at the problem from a public health perspective). This approach focuses on the presence or absence of the cost of alternatives associated with the widespread prevalence of COVID-19 care.
The panelists compiled a rating of outcomes, in which a high rank was assigned to even a small reduction in mortality. In addition, even a slight decrease in the need for mechanical ventilation was assigned a high rank, the use of which is a tangible physical effect for patients and a significant emotional impact for both patients and their families.
Another reason for giving a high rank to a slight decrease in the need for mechanical ventilation is related to the resource equipment of healthcare: the availability of mechanical ventilation during the COVID-19 pandemic is a significant problem. It should be noted that transferring a patient to controlled breathing requires a stable source of oxygen, as well as the availability of trained personnel, which is also an important issue during the COVID-19 pandemic, especially in conditions of limited resources.