蘇生科学の研究の主なアウトカム:アメリカ心臓協会のコンセンサス声明
Circulation
|October 5, 2011
まとめ
心臓発作停止試験の最良の初等結果の選択は複雑である. 合意は,時間点と生理学的条件をペアリングし,大規模な公衆衛生研究のための長期的な神経認知評価を提案しています.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- クリニック・トライアル 臨床試験
背景:
- 心停止の治療法は,高品質の臨床試験に依存しています.
- 有意義なプライマリアウトカム選択は極めて重要だが,論争の的だ.
- この問題に対処するために,コンセンサス会議で専門家,NIH,FDAを招集した.
研究 の 目的:
- 心停止の臨床試験における主要なアウトカムを選択するためのガイドラインを提供すること.
- プライマリ・アウトカム・セレクションをめぐる論争を解決するために.
- 研究者,臨床医,審査者,規制当局を導くために.
主な方法:
- 心血管疾患および神経学的アウトカムに関する多様な視点を持つ専門家の指名.
- 会議前の文書と会議後のコンセンサス文書の回転を審査する.
- 議論は,測定時間点,生理学的評価,エンドポイントコストに焦点を当てました.
主要な成果:
- すべての心臓停止研究に適合する単一の主要なアウトカムはありません;最良の測定は,生理学的条件と時間点をペアします.
- 以前の研究では,以前の時間点 (例えば,自発的な循環の回復,生存) を使用することがあります.
- より大きな試験では,神経認知および生活の質の評価を含むより長い時間点 (例えば90日) を考慮する必要があります.
結論:
- 脳のパフォーマンスカテゴリーまたは90日後に修正されたランキンスケールは,多くの試験の合理的な結果です.
- 検証され,簡単に管理できる神経学的機能的アウトカム測定法が必要である.
- 将来の開発は,心停止後の患者の神経学的機能的アウトカム測定を優先すべきである.
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