OBJECTIVE To construct a clinical comprehensive evaluation system for low molecular weight heparin(LMWH) in the prevention and treatment of recurrent spontaneous abortion(RSA), from the perspective of rational drug use. This system aims to provide methodological support for clinical drug selection and pharmaceutical management decisions.

METHODS Using LMWH in RSA prevention and treatment as a case study, multi-criteria decision analysis was employed. Through literature review, scoring results from 27 experts, and a preset indicator pool, the processes sequentially included process sorting, framework construction, weight determination, assignment criteria establishment, and comprehensive scoring.

RESULTS The clinical comprehensive evaluation process for drugs included five core steps: determination of the decision-making problem, formulation of the evaluation framework, acquisition of indicator performance, determination of indicator assignment criteria, and calculation of comprehensive scores. The evaluation framework covered five primary dimensions(effectiveness, safety, economy, suitability, and accessibility) and 19 secondary indicators. Among these, effectiveness(weight 33.87%) and safety(weight 34.85%) were identified as the core dimensions, with 100% of the 27 experts agreeing that both were "very important". The comprehensive evaluation showed that low molecular weight heparin sodium had the highest comprehensive score(86.30 points), while dalteparin had the lowest(69.98 points).

CONCLUSION The evaluation system established in this study is methodologically rigorous and can be extended to the clinical comprehensive evaluation of specialized drugs during pregnancy or other drugs for chronic diseases, providing a reference for hospital pharmacists in related work.