用于优化卫生干预和实施策略的实验设计:范围审查
Erin Nolan1,2,3, Luke Wolfenden4,5,6,7, Taylor Benn4
1School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. Erin.nolan@hmri.org.au.
BMC health services research
|August 26, 2025
概括
这次审查考察了优化卫生干预和实施策略的研究设计. 结果强调需要更明确的成功标准和框架,为未来的试验提供适应性设计.
科学领域:
- 医疗服务研究
- 实施科学
- 临床试验设计
背景情况:
- 优化是加强卫生干预和实施战略的关键代过程.
- 了解当前的研究设计对于提高优化过程的效率和有效性至关重要.
研究的目的:
- 确定用于评估健康干预和实施战略的优化研究设计.
- 根据具体的优化目标来确定研究设计是否有所不同.
- 提出加强未来优化试验的策略.
主要方法:
- 在多个数据库 (Medline,EMBASE,CINAHL,ProQuest护理和盟友健康来源) 进行了全面的范围审查.
- 还检查了临床试验注册,以确定正在进行或已完成的相关试验.
- 数据提取重点是研究设计,优化目标,限制以及优化框架和成功标准的使用.
主要成果:
- 总共包括183项研究,重点是干预优化 (n=142),实施战略优化 (n=39) 或两者兼而有之 (n=2).
- 在干预优化方面,因数设计最常见 (41%),而前后设计则主导实施战略优化 (46%).
- 只有11%的试验有明确的优化成功定义,24%的试验使用了优化框架.
结论:
- 该审查描述了健康优化试验中的当前设计特征.
- 需要标准化框架来指导试验设计,并明确定义优化成功.
- 建议采用适应性设计和贝叶斯统计等替代方法来应对共同的挑战并改善优化对齐.
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