可视化外部有效性:图形显示以告知治疗效果从试验到临床实践的延伸
Jennifer L Lund1,2, Michael A Webster-Clark1,3, Daniel Westreich1
1From the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
这项研究提供了一个实用的路线图和可视化,以帮助研究人员将治疗效应从临床试验扩展到现实世界的实践. 这些工具有助于变量选择和模型评估,以更好地概括试验结果.
科学领域:
- 生物统计学 生物统计学
- 临床流行病学临床流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 随机对照试验 (RCT) 的治疗效果估计可能在临床实践中缺乏有效性,因为效果测量修改.
- 将RCT治疗效应扩展到临床实践的定量方法是一个活跃的研究领域.
研究的目的:
- 为研究人员提供实用的路线图和可视化,用于扩展试验治疗效果的模型中选择变量.
- 帮助评估模型规范和性能,并将发现推广到临床实践中.
主要方法:
- 开发一个概念路线图和四个可视化的变量选择和模型评估.
- 将路线图和可视化应用到结肠癌辅助化疗的一个例子中,将试验数据扩展到社区瘤实践人群中.
主要成果:
- 第一个可视化识别了模型包含的潜在效果测量修饰器.
- 第二个可视化评估试验和临床实践人群之间的共变重叠.
- 额外的可视化处理模型规范和有影响的观察,指导假设查询的概括性.
结论:
- 拟议的路线图和可视化为从RCT向临床实践环境量化扩展治疗效果提供了实际指导.
- 这些工具支持在现实环境中将试验证据应用于各种患者群体的知情决策.
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