在实施研究中,推出试验设计往往是必要的,有时是首选的
Gregory E Simon1, Bryan R Garner2, Justin D Smith3
1Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. #1360, Seattle, WA, 98101, USA. gregory.e.simon@kp.org.
Implementation science : IS
|February 25, 2025
概括
推广设计,包括分阶试验,比传统的平行组设计提供了伦理,科学和实际的优势. 这些分阶段实施策略适用于评估新计划和政策变化.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床试验设计 临床试验设计
- 实施科学 实施科学
背景情况:
- 推广设计,如阶梯,涉及到分阶段实施程序或服务.
- 人们担心在推出设计中存在混效应,因此提出了限制其使用的建议.
- 然而,由于伦理,科学或实际考虑,推广设计可能比平行组设计更合适.
研究的目的:
- 定义并为阶段和其他推出试验设计提供理由.
- 用最近试验的例子来说明这些设计的应用.
- 总结推出设计的优点和缺点.
主要方法:
- 调查使用推广设计的伦理,科学和实际原因.
- 定义阶梯和更广泛的推广设计,所有单位最终都会接受干预.
- 分析已完成和正在进行的推出试验的例子.
主要成果:
- 阶段性实施在伦理上是必要的,当推迟有效服务是不可接受的.
- 与平行组设计相比,阶梯形设计提供了更高的统计能力.
- 推广设计可以容纳跨实施阶段的比较,并解决后勤或社区约束.
结论:
- 阶段和推广试验设计对于评估实施策略和政策变化是有效的.
- 这些设计在实施试验中通常是出于实际,伦理或科学原因所必需的.
- 了解推出设计的具体优点和缺点对于适当的应用至关重要.
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