在随机实施试验中使用常规医疗保健数据:一种方法学混合方法的系统审查
Charis Xuan Xie1, Lixin Sun2, Elizabeth Ingram3
1Wolfson Institute of Population Health, Queen Mary University of London, London, England, UK. charis.xie@qmul.ac.uk.
Implementation science : IS
|October 2, 2023
概括
常规数据通过帮助参与者识别和结果评估来增强随机实施试验. 提高数据质量和标准化报告是有效利用医疗保健研究的关键.
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
- 实施科学 实施科学
背景情况:
- 常规数据越来越多地被用于医疗干预的随机对照试验.
- 这些数据支持参与者识别,结果评估和干预交付.
- 虽然它们在有效性试验中的使用是已知的,但它们在实施试验中的应用较少被探索.
研究的目的:
- 描述在随机实施试验中常规数据的利用.
- 描述这些试验的设计特征.
主要方法:
- 进行了对MEDLINE和Cochrane控制试验中央注册表 (2000年1月至2021年12月) 的系统搜索.
- 包括实施试验和使用常规数据的混合有效性-实施试验.
- 提取了定量和定性数据,并以叙事方式进行了合成.
主要成果:
- 包括80项试验,其中22.5%专注于临床指南的实施.
- 多组件策略 (70.0%) 比单一策略更为常见,在65.0%的试验中,采用是主要结果.
- 电子健康记录 (EHR) 是最常见的来源 (62.5%),其中91.3%使用常规数据来确定结果;效率和减少研究负担是使用的主要原因.
结论:
- 对实施策略和结果的标准化报告对于研究识别和数据提取至关重要.
- 常规医疗保健数据对多个试验方面非常有价值.
- 解决数据质量和电子健康记录系统局限性等障碍对于有效的日常数据利用至关重要.
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