语境影响:如何量化它们,以及如何不量化它们
Tobias Saueressig1,2, Hugo Pedder3, Patrick J Owen4
1Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany. t.saueressig@physiomeetsscience.com.
讨论了临床护理中的上下文影响. 这项研究建议比较安慰剂和无治疗组,以准确测量这些影响,为更好的临床研究实践提供指导.
科学领域:
- 临床研究方法论 临床研究方法论
- 基于证据的医学基于证据的医学.
- 精神病体医学是一种精神病体医学.
背景情况:
- 在临床护理中,上下文效应的作用和规模仍然存在争议.
- 以前的审查已经产生了关于安慰剂干预疗效的相互矛盾的结论.
- 在量化上下文效应方面的方法限制有助于差异.
研究的目的:
- 在临床研究中批判性地评估估计上下文影响的方法.
- 提出一个最佳的方法来量化上下文效应.
- 提供关于估计上下文影响的最佳实践的明确指导.
主要方法:
- 分析现有的系统审查和量化上下文影响的方法.
- 不同方法的比较,包括安慰剂对照组和比例上下文效应.
- 一种新方法的建议:安慰剂和未接受治疗的对照组之间的差异.
主要成果:
- 科克莱恩综述 (2010) 低估了因有缺陷的量化方法而导致的上下文影响.
- 2010年后的审查表明了更大的上下文效应,通常源于不适当的分析技术.
- 仅使用安慰剂对照组或计算"比例上下文效应"被确定为有限的方法.
结论:
- 准确估计上下文效应对于理解总治疗效应至关重要.
- 拟议的将安慰剂与未接受治疗的组进行比较的方法提供了更可靠的量化.
- 实施标准化最佳实践将提高临床试验结果的可靠性.
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