在手术和IDEAL的临床研究进展
Peter McCulloch1, Joshua Feinberg2, Yiannis Philippou1
1Nuffiled Department of Surgical Science, University of Oxford, Oxford, UK.
Lancet (London, England)
|January 24, 2018
概括
提高外科研究质量至关重要. IDEAL框架有助于评估,显示报告标准的进展,但复杂的干预研究仍然存在挑战.
科学领域:
- 手术研究方法
- 临床试验评估
- 在外科手术中的基于证据的医学
背景情况:
- 由于许多治疗方法的证据不足,手术研究质量受到批评.
- 缺乏证据会影响资金,创新采用和患者安全.
- IDEAL框架 (概念,开发,探索,评估,长期跟进) 提供了一种结构化的外科研究评估方法.
研究的目的:
- 通过IDEAL建议评估手术研究的方法进步.
- 评估IDEAL框架的采用和影响.
- 确定阻碍外科研究进一步方法的挑战.
主要方法:
- 对2000年至2004年和2010年至2014年的外科研究进行比较分析.
- 评估方法元素,包括结果测量,报告标准 (CONSORT) 和外科质量评估.
- 评估IDEAL框架的采用和对外科研究实践的影响.
主要成果:
- 在标准结果测量,CONSORT合规性,手术质量和学习曲线的评估中观察到明显的改善.
- 在使用定性研究或在程序开发过程中报告修改方面没有发现显著进展.
- IDEAL框架的采用正在加速,复杂干预的综合评估方法越来越受欢迎.
结论:
- 虽然手术研究的方法改进是显而易见的,但仍然存在挑战,特别是在定性方面和适应性试验报告方面.
- IDEAL框架在指导手术程序和复杂干预的严格评估方面表现有前途.
- 进一步进步需要加强研究教育,将其纳入常规实践,并与认可系统保持一致.
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