在养老院的集群随机试验应该更好地作为开放的队列而不是作为封闭的队列来规划
Pierre Poupin1, Agnès Caille1, Wassim Gana2
1INSERM, SPHERE, U1246, Tours University, Nantes University, Tours, France; INSERM CIC 1415, Tours University Hospital, Tours, France.
Journal of clinical epidemiology
|June 26, 2023
概括
开放式队列设计是大多数养老院集群随机试验的可行替代方案,通过减少参与者消耗,为封闭式队列设计提供了优势. 在未来的研究中,应该更频繁地考虑这种设计.
科学领域:
- 老年学是一门学科.
- 临床试验方法论 临床试验方法论
- 公共卫生 公共卫生
背景情况:
- 在养老院的集群随机试验 (CRT) 通常使用一个封闭的队列设计,遵循固定的一组居民.
- 另一种选择,即开放式队列设计,对每个评估点上的所有居民进行评估,包括新入学的个人.
- 开放式队列设计的使用较少,但可以减轻个人消耗等问题.
研究的目的:
- 评估在历史上使用封闭队列设计的养老院CRT中实施开放队列设计的可行性.
- 确定开放式队列设计是否适合在养老院环境中进行干预的替代方案.
主要方法:
- 对22项已发表的集群随机试验的综述,这些试验是在使用封闭队列设计的养老院中进行的.
- 评估开放队列设计对所选试验的适用性,考虑到居民招生和干预暴露.
主要成果:
- 在22项审查的试验中,开放式队列设计被认为是20项相关的替代方案.
- 在大多数情况下 (16项试验),新入住的居民可以参与并从干预中受益.
- 在两项试验中,即使采用开放式队列设计,新入住的住户也无法从干预中受益.
结论:
- 开放式队列设计非常适合在大多数在养老院CRT中评估的干预措施.
- 研究人员应该更频繁地考虑和采用护理院CRT的开放队列设计.
- 这种设计提供了潜在的好处,特别是在减少消耗偏差和反映现实世界的实践.
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