根据大规模实用性嵌入式临床试验的参与状态,VA医院的特征
Genevieve Dupuis1, Ryan E Ferguson2, Areef Ishani3
1Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
设施研究经验和质量护理指标影响参与实用临床试验. 了解这些因素是成功招募多地点试验的关键,特别是对于新研究的设施.
科学领域:
- 临床试验 临床试验
- 医疗保健服务研究 医疗服务研究
- 心血管医学 心血管医学
背景情况:
- 利尿剂比较项目 (DCP) 是VA系统内的实用性试验,用于高血压患者的甲和甲进行比较.
- 分散的研究程序需要在参与者入学之前获得设施领导的批准.
- 研究了参与和非参与设施之间的潜在差异.
研究的目的:
- 为了比较参与DCP试验的VA医疗中心的特征与没有参与的VA医疗中心的特征.
- 确定影响大型多中心实用性临床试验机构招生因素.
主要方法:
- 一个横截面分析比较了参与和非参与的VA医疗中心,使用了2016年6月的数据.
- 数据来源包括美国社区调查,改善和学习战略分析报告,星级评级和医院复杂性.
- 后勤回归分析了县级社会经济和医院级绩效特征.
主要成果:
- 在144个VA医疗中心中,有75个 (52%) 参与.
- 城市,高收入县和复杂度较高的地区的设施更有可能参与.
- 具有先前研究经验的设施参与的可能性是2.18倍;其他指标显示没有关联.
结论:
- 设施研究暴露和质量指标似乎会影响参与实用试验.
- 这些发现对于优化多站点临床试验的招聘策略至关重要.
- 建议支持研究历史较少的设施,并教育实用性试验设计.
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