脆弱性作为随机对照试验中的效果修饰者:系统性审查
Aaron Yao1,2, Linhui Gao3, Jiajun Zhang4
1VillageMD Research Institute, Chicago, IL, USA. ayao@villagemd.com.
Journal of general internal medicine
|April 9, 2024
概括
临床干预的有效性因患者的脆弱性而异. 根据个体脆弱程度量身定制治疗方法可以优化护理,并防止老年人不适当的干预.
科学领域:
- 老年学是一门学科.
- 临床药理学 临床药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 临床干预的有效性可能会受到患者虚弱的影响.
- 了解脆弱性在治疗反应中的作用对于个性化医学至关重要.
- 在老年人中,以脆弱为指导的策略可能会减少过度治疗和治疗不足.
研究的目的:
- 系统地审查随机对照试验 (RCT),检查治疗效果因脆弱性而发生的修改.
- 评估脆弱性如何影响药物,非药物和多组分干预的结果.
主要方法:
- 在主要数据库 (PubMed,科学网,EMBASE,临床试验.gov) 进行系统搜索,截至2023年12月8日.
- 两个审稿人的独立数据提取和质量评估.
- 包括61个评价老年人的脆弱性和治疗效果的RCT.
主要成果:
- 对于几个药理干预措施 (例如,埃多克萨班,化疗),治疗效果因脆弱性状态而有显著差异.
- 一些干预措施 (例如,抗高血压药物,疫苗接种) 在所有脆弱程度上都显示出一致的好处.
- 非药物干预证明了基于脆弱性严重性的差异性益处,其中一些在较高的脆弱性中有效,而其他在较低的脆弱性人群中有效.
结论:
- 脆弱性是改变老年人临床干预疗效的一个重要因素.
- 这些发现支持制定以脆弱为指导的治疗建议.
- 根据脆弱状态来个性化干预对于优化患者的治疗结果至关重要.
更多相关视频
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
16.6K
07:27Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
10.2K
相关概念视频
01:52Regression Toward the Mean
6.3K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.3K
01:13Randomized Experiments
6.9K
The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Simple randomization
Simple...
6.9K
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
126
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
126
01:12Hazard Ratio
116
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
116