死んだ患者の治療経歴を復活させる: 休息すべき研究設計
Peter B Bach1, Deborah Schrag, Colin B Begg
1The Health Outcomes Research Group, the Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. bachp@mskcc.org
JAMA
|December 9, 2004
まとめ
死ぬ前の介護を調査する死者の研究は,死にかけている患者の介護を不正確に表現することがあります. 患者選択と時間枠の差異は,重大なバイアスを導入し,終末介護の品質に関する潜在的に無効な結論につながります.
科学分野:
- 緩和ケアに関する研究
- 医療サービス 研究 医療サービス
- 腫瘍学 腫瘍学
背景:
- 死者に関する研究は,死前の介護を分析する.
- 死にかけている患者の研究は,終末状態が認識された後のケアに焦点を当てています.
- 既存の研究方法は,終末期ケアを正確に反映していない可能性があります.
研究 の 目的:
- 瀕死の患者の介護を描写する"死者の研究"の正確さを評価する.
- これらの研究型における異なる被験者識別と時間帯によってもたらされるバイアスを識別する.
- 死亡者に関する研究から得られた終末期ケアに関する結論の妥当性を評価する.
主な方法:
- "死者の研究"と"死にかけている患者の研究"の比較分析.
- 科目選択基準の検討と時間的な検討期間.
- 図示的な例として,人口ベースのがん患者コホートを使用する.
主要な成果:
- 死者の研究における被験者選択の違いによって,重大なバイアスが導入されます.
- 分析のために選択された時期は,研究解釈に大きな影響を与えます.
- この2つの要因は,死にかけている患者の介護の潜在的に不正確な肖像画につながります.
結論:
- 死者に関する研究は,死にかけている患者のケアの質について無効な結論を生む可能性があります.
- 科目選択と時間枠における方法論的差異は,重要な制限である.
- 終末期介護の研究へのアプローチを再考することが必要である.
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