関連する実験動画
Updated: May 2, 2026

05:21
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
5.4K
実践に基づく戦略が,初等医療従事者のテストオーダーのパフォーマンスに与える影響:ランダム化試験
Wim H J M Verstappen1, Trudy van der Weijden, Jildou Sijbrandij
1Center for Quality of Care Research, Department of General Practice, Maastricht University, Maastricht, The Netherlands. wim.verstappen@hag.unimass.nl
JAMA
|May 15, 2003
まとめ
新しい戦略により,主治医が注文する不必要な診断検査を減らすことができました. 臨床ガイドラインとフィードバックを用いたこのアプローチは,テストオーダーのパフォーマンスのわずかな改善を示しました.
科学分野:
- プライマリーケア医療 プライマリーケア医療
- 医療サービス 研究 医療サービス
- 証拠に基づいた実践
背景:
- プライマリケア医師 (PCP) によって注文される診断検査の数が増加しているため,不必要な利用に関する懸念が高まっています.
- 確立された証拠に基づいたガイドラインは,テスト注文の慣行を最適化する必要性を強調しています.
研究 の 目的:
- プライマリケア医師のテストオーダーのパフォーマンスを向上させるために設計された多面的な戦略を評価する.
- ガイドラインに基づくフィードバックと社会的相互作用が診断テストの利用に与える影響を評価する.
主な方法:
- バランスのとれた不完全なブロック設計による多センター,ランダム化制御試験が採用されました.
- オランダの5つの地域で26のプライマリケア医師グループ (174人の医師) が参加しました.
- ガイドラインの議論,個人のフィードバックレポート,行動計画を含む介入が6ヶ月間にわたって実施されました.
主要な成果:
- 介入を受けた医師は,割り当てられた臨床問題 (アームA) に対して注文された検査の合計で12%の減少を示しました.
- A腕では不適切な検査の有意な減少が見られたが,B腕では有意な減少が見られた.
- この介入により,対照群 (P=.01) と比較して,A群では6ヶ月間にわたって医師1人当たりの検査が平均67回減少した.
結論:
- ガイドライン,フィードバック,および社会的相互作用を組み込んだ実践に基づく多面的な戦略は,プライマリケア医師のテスト注文に控えめな改善をもたらしました.
- この調査結果は,標的型介入が,初等医療施設における診断テストの活用に積極的な影響を与える可能性があることを示唆している.
関連する概念動画
Group Design
9.3K
The most basic experimental design involves two groups: the experimental group and the control group. The two groups are designed to be the same except for one difference— experimental manipulation. The experimental group gets the experimental manipulation—that is, the treatment or variable being tested—and the control group does not. Since experimental manipulation is the only difference between the experimental and control groups, we can be sure that any differences between...
9.3K
Blind Procedures
10.8K
Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
10.8K
Obedience
26.2K
According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
26.2K
Randomized Experiments
6.3K
The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Simple randomization
Simple...
6.3K
Blinding
2.9K
Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.
2.9K
Bioequivalence Experimental Study Designs: Repeated Measures, Cross-Over, Carry-Over, and Latin Square Designs
419
Bioequivalence experimental study designs play a pivotal role in testing the effectiveness of various treatments. Key among these are the repeated measures, cross-over, carry-over, and Latin square designs. In the repeated measures design, each subject receives all treatments, allowing for temporal comparisons. This type of design is useful in reducing variability but requires careful planning to avoid bias.The cross-over design, an economical method, involves sequential administration of...
419

