Watson Bill, Procter Susan, Cochrana Wendy
School of Health, Community and Education Studies, Northumbria University, UK.
Nurse Res. 2004;11(3):28-42. doi: 10.7748/nr2004.04.11.3.28.c6203.
The commissioning of healthcare services is increasingly linked to the availability of rigorous evidence of clinical and cost effectiveness. In the current climate, 'rigorous evidence' is synonymous with the randomised controlled trial (RCT). Consequently, health technologies are often funded in preference to service developments due to an imbalance in the availability of strong evidence to support service developments. Simultaneously, there is an increasing policy emphasis on patient choice and individualized care in the NHS. In this paper Bill Watson, Susan Procter and Wendy Cochrane discuss the implications of using experimental methods in service development research, with reference to an ongoing RCT evaluating the component parts of pulmonary rehabilitation in people with chronic obstructive pulmonary disease (COPD).
医疗服务的委托越来越多地与临床和成本效益的严格证据的可用性联系在一起。在当前环境下，“严格证据”与随机对照试验（RCT）同义。因此，由于支持服务发展的有力证据在可得性上存在不平衡，卫生技术往往比服务发展更受青睐而获得资金。同时，英国国家医疗服务体系（NHS）越来越强调患者选择和个性化护理的政策。在本文中，比尔·沃森、苏珊·普罗克特和温迪· Cochrane 参考一项正在进行的评估慢性阻塞性肺疾病（COPD）患者肺康复组成部分的随机对照试验，讨论了在服务发展研究中使用实验方法的影响。
