在实用临床试验中优化多样性,公平性和包容性:疼痛管理协作实验室的发现
Travis I Lovejoy1, Amanda M Midboe2, Diana M Higgins3
1Department of Psychiatry, Oregon Health & Science University, Portland, OR; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
The journal of pain
|November 6, 2024
概括
疼痛管理协作室 (PMC) 改善了非药物治疗疼痛的实用临床试验的招聘和保留率. 网站选择和数据信息学等策略有助于多样性,但注意到了对多样性的狭定义.
科学领域:
- 临床研究 临床研究
- 疼痛管理 疼痛管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 国家卫生研究院,国防部和退伍军人事务部于2017年建立了疼痛管理协作室 (PMC).
- 该PMC旨在在军事和退伍军人医疗保健系统中实施和评估非药物疼痛管理策略.
- 实用临床试验被用来评估这些方法的疼痛和同时发生的条件.
研究的目的:
- 在PMC的大规模,多站点实用性临床试验中批判性地检查招聘和保留程序.
- 评估试验参与者为多样化研究样本所做的努力.
- 为临床疼痛研究中多样化患者样本提供建议.
主要方法:
- 半结构面试与PMC内的11个实用临床试验的团队成员进行了半结构面试.
- 面试的重点是对多样性的定义,各种样本的招聘和保留方法,以及计划的子组分析.
- 分析了近18,000名注册患者的数据,并注意到人口统计学特征.
主要成果:
- 诸如研究地点选择,患者组合作伙伴关系和数据信息学等策略,促进了招募多样化的患者群体.
- 招募的患者包括22%在出生时被分配给女性,34%来自边缘化的种族或种族群体.
- 一个值得注意的发现是,试验者采用了狭的多样性定义,忽视了交叉的身份.
结论:
- PMC的经验强调了在疼痛实用临床试验中多样化患者样本的挑战和机遇.
- 提供了建议,以加强对历史上代表性不足的社会身份群体的纳入疼痛研究.
- 优化多样化人群的包容性对于推动临床疼痛研究和管理至关重要.
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