用PRECIS-2工具评估肺癌查随机试验的实用性
Erin A Hirsch1, Jamie L Studts2, Susan Zane2
1From the Cancer Prevention Precision Control Institute, Cancer for Discovery & Innovation at Hackensack Meridian Health, Nutley, NJ, and University of Colorado School of Medicine, Department of Medicine, Division of Medical Oncology, Aurora, CO (EAH); Professor, Department of Medicine, Division of Medical Oncology, University of Colorado School of Medicine, Aurora, CO, Co-Leader, Cancer Prevention and Control Program, University of Colorado Cancer Center, Aurora, CO (JLS); University of Colorado School of Medicine, Department of Family Medicine, Aurora, CO (SZ); Colorado School of Public Health, Department of Health Systems Management and Policy, Aurora, CO (MM); University of Colorado School of Medicine, Department of Medicine, Division of General Internal Medicine, Adult and Child Center for Outcomes Research and Delivery Science, Ludeman Family Center for Women's Health Research, Aurora, CO (AGH). Erin.Hirsch@cuanschutz.edu).
肺癌查 (LCS) 的随机临床试验往往对现实世界初级保健过于解释性. 应用PRECIS-2工具显示,这些试验需要广泛的支持,在典型的社区环境中无法获得.
科学领域:
- 公共卫生 公共卫生
- 临床试验方法论 临床试验方法论
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在社区和农村初级保健中实施肺癌查 (LCS) 存在挑战.
- 支持LCS的随机临床试验 (RCT) 可能使用不反映初级保健环境的解释方法.
研究的目的:
- 从初级保健角度评估使用PRECIS-2工具的LCSRCT的务实性.
- 评估LCS RCT是否适合去中心化,初级保健实施.
主要方法:
- 从元分析中确定了LCS RCT,并将VA演示项目作为比较器.
- 两个独立评价者在5分级别上对9个PRECIS-2领域进行了评估 (1=解释性,5=实用性).
- 每项研究和每个领域的PRECIS-2分数的计算平均值.
主要成果:
- 评估了11个RCT和VA演示项目,平均得分从2.12到3.33不等.
- 大多数RCT在解释性领域 (资格,招聘,设置,组织,员工灵活性,后续行动) 的得分较低.
- 在实用领域 (依从性,结果,分析) 的RCT得分更高.
结论:
- LCS RCT通常倾向于解释性质.
- 在LCS RCT中,基础设施和支持往往超过了典型的美国初级保健机构的容量.
- 研究结果表明,对于在初级保健中实施LCS,需要更务实的试验设计.
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