心脏手术中的随机试验:为什么以及如何
Mario Gaudino1, Matthias Siepe2, Gavin J Murphy3
1Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
概括
心脏手术中的随机临床试验 (RCT) 面临挑战,但最近的努力正在改善参与率. 未来的战略对于通过增加RCT采用来推进心脏外科手术至关重要.
科学领域:
- 心胸外科手术 心胸外科手术
- 临床试验 临床试验
- 相对有效性研究研究比较
背景情况:
- 随机临床试验 (RCT) 对于比较有效性至关重要,但由于其独特的挑战,在心脏外科手术中未得到充分利用.
- 解决这些障碍对于推进现场基于证据的实践至关重要.
研究的目的:
- 要总结阻碍心脏手术中的RCT所面临的挑战.
- 描述最近采取的减轻这些障碍的举措.
- 概述未来在心脏手术中加强RCT采用的机会.
主要方法:
- 基于2024年欧洲心胸外科协会 (EACTS) 年会讨论的专家分析.
- 审查试验支持基础设施,如ROMA网络,CTSN,GCRFF和英国模型.
- 识别用于克服RCT障碍的机制,并推断未来的趋势.
主要成果:
- 各种试验支持基础设施旨在增加心脏RCT.
- 策略包括通过实习生,利益相关者和患者招聘来加强试验参与.
- 促进资金和促进更广泛的合作是关键成果.
结论:
- 随机试验对于心脏手术的临床进步至关重要,但仍未得到充分利用.
- 最近的举措已经成功地减少了心脏手术RCT的多因素障碍.
- 需要持续有意的努力,通过RCT进一步推进专业.
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