报告不足的上下文因素妨碍了初级保健随机对照试验中的适用性评估
Aristea Missiou1, Eleni Ntalaouti1, Christos Lionis2
1Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Journal of clinical epidemiology
|June 13, 2023
概括
在初级保健随机对照试验 (RCT) 中报告的上下文因素非常低. 这种报告不足危害了对这些重要的健康研究的适用性评估.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床试验方法论 临床试验方法论
- 初级保健研究研究初级保健研究
背景情况:
- 在初级保健 (PC) 中,随机对照试验 (RCT) 对于基于证据的实践至关重要.
- 评估PC RCT结果在现实环境中的适用性对于有效实施至关重要.
- 当前的报告标准可能无法充分捕捉适用性评估中至关重要的元素.
研究的目的:
- 评估初级保健RCT中可适用性报告的程度和质量.
- 确定PC RCT中经常报告不足的特定适用性元素.
- 为改善PC试验出版物的报告准则提供信息.
主要方法:
- 分析了2000年至2020年间发表的初级保健RCT的随机样本.
- 数据提取集中在设置,人口,干预 (包括实施),比较器,结果和上下文.
- 根据提取的数据,对五个预定义的适用性问题报告的充分性进行了评估.
主要成果:
- 干预措施,人口特征和实施细节等关键要素经常被报告 (>50%).
- 背景因素,如跨群体的差异性影响,定制干预措施和卫生系统结构,被显著低于报告 (<40%).
- 试验中充分解决每个适用性问题的比例从1%到20.2%不等,没有一个试验能够解决所有问题.
结论:
- 在初级保健RCT中对上下文因素的报告不足,严重阻碍了对其适用性的评估.
- 改善对上下文因素的报告是必要的,以提高初级保健研究结果的概括性和实用性.
- 加强PC RCT报告准则的建议是有必要的,以改善适用性评估.
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