基于德尔菲法及层次分析法构建免疫规划疫苗遴选评估框架

Establishment of an evaluation framework for selecting vaccines to be included into planned immunization of Shenzhen city using Delphi method and analytic hierarchy process

目的构建非免疫规划疫苗纳入深圳市免疫规划的评估框架。方法通过文献分析,初步形成指标框架;于2022年3—7月采用2轮德尔菲专家咨询法对15名专家进行问卷调查,以修改完善指标,确定指标体系;采用层次分析法确定指标权重。结果2轮专家咨询的专家积极系数(C_(aj))分别为100%、86.67%,专家权威系数(Cr)均值为0.84;第一轮、第二轮专家咨询所有指标综合评分的协调系数(W)分别在0.199~0.465、0.253~0.442之间(P均<0.05);最终确定了由4个一级指标、13个二级指标和34个三级指标形成的指标体系,分别从疾病评价(疾病负担、经济负担、防控优先性)、疫苗评价(疫苗安全性、疫苗效果、疫苗属性)、能力评价(决策过程、资金、供应、人力、监测)和效益评价(经济效益、社会效益)等4个维度进行评价,其中所有三级指标的组合权重系数在0.003~0.279。结论本研究构建的深圳市免疫规划疫苗遴选评估框架具有创新性与可靠性,可为深圳市免疫规划疫苗遴选提供参考。

Objective To construct an evaluation framework for prioritizing the inclusion of non-program vaccines into planned immunization of Shenzhen city.Methods After developing a preliminary evaluation framework with literature studies,we conducted two rounds of Delphi consultation among 15 experts for screening relevant indicators and modifying the framework during March–July 2022.The weight of each indicator in the framework was calculated using analytic hierarchy process.Results The active coefficients for the two rounds of expert consultation were 100%and 86.67%and the expert authority index was 0.84 for the two rounds of consultation.The concordance coefficients for the experts′comprehensive evaluation scores of all indicators ranged between 0.199–0.465(P<0.05)and 0.253–0.442(P<0.05)in the first and second consultation.Totally 4 primary,13 secondary and 34 tertiary indicators were included in the finally established evaluation framework for assessing the priority of a non-program vaccine to be included into planned immunization on 4 dimensions:disease impact(disease burden,economic burden,prevention urgency),vaccine effect(safety,efficacy,related attributes),vaccination feasibility(policy making,fund,vaccine supply,human resource,surveillance),and cost-effectiveness(economic and social benefit).The combined weights were between 0.003 and 0.279 for all the indicators.Conclusion The established evaluation framework is innovative and reliable and could provide a reference tool in selecting a vaccine to be included into Shenzhen municipal immunization program.