对实用性随机对照试验的厌恶:在美国,对临床医生和非专业人士进行了三项调查实验
Randi L Vogt1, Patrick R Heck1, Rebecca M Mestechkin1
1Bioethics & Decision Sciences, Geisinger, Danville, Pennsylvania, USA.
BMJ open
|September 17, 2024
概括
临床医生和非专业人士对实用随机对照试验 (pRCT) 显示出明显的实验厌恶. 解决这种厌恶对于推进基于证据的医学和改善医疗保健干预措施至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床试验 临床试验
- 行为科学 行为科学
背景情况:
- 实用随机对照试验 (pRCT) 对于实际的医疗干预评估至关重要.
- 实验厌恶,即偏好实施没有比较的干预措施,在公众和临床医生中都是常见的.
- 随着COVID-19大流行,围绕PRCT的紧迫性和公共话语加剧了.
研究的目的:
- 调查公众和临床医生对pRCT的看法,无论是COVID-19还是非COVID-19干预措施,在大流行期间是否变得更加积极.
- 在不同的背景下量化实验厌恶程度.
主要方法:
- 随机调查实验与美国的临床医生和平民进行.
- 参与者评估了涉及干预选择的假设场景:实施A,实施B,或实验性地比较A和B.
- 对实验的厌恶程度是由参与者对实验比较的评价低于他们喜欢的干预措施来衡量的.
主要成果:
- 对于非COVID-19干预措施 (导管检查清单,高血压药物) 和大多数非药物COVID-19干预措施 (口罩协议,proning) 观察到显著的实验厌恶.
- 对药物COVID-19干预措施 (新药,疫苗协议) 发现的实验厌恶率最低.
- 28%-57%的参与者表达了对实验的厌恶,而只有6%-35%的人表达了对实验的欣赏.
结论:
- 在临床医生和平民中,对实验的厌恶仍然存在,即使在疫情期间也增加了对pRCT的需求.
- 解决实验厌恶对于推进基于证据的医学至关重要.
- 需要采取减轻实验厌恶的策略,以促进pRCT在医疗保健中的采用.
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