Allmark P
Samuel Fox House, Northern General Hospital, Sheffield, UK.
J Med Ethics. 2004 Apr;30(2):185-9. doi: 10.1136/jme.2003.004374.
Recent research governance documents say that the body of research evidence must reflect population diversity. The response to this needs to be more sophisticated than simply ensuring minorities are present in samples. For quantitative research looking primarily at treatment effects of drugs and devices four suggestions are made. First, identify where the representation of minorities in samples matters-for example, where ethnicity may cause different treatment effects. Second, where the representation of a particular group matters then subgroup analysis of the results will usually be necessary. Third, ensuring representation and subgroup analysis will have costs; deciding on whether such representation is worthwhile will involve cost benefit analysis. Fourth, the representation of minorities should not be seen as mainly a locality issue. For qualitative research it is argued that the representation of diversity is often important. Given the small samples of many qualitative projects, however, the best way to ensure representation occurs is to allow a proliferation of such research, not to stipulate such representation in samples.
最近的研究治理文件指出,研究证据主体必须反映人群多样性。对此的应对措施需要比仅仅确保样本中有少数群体更为精细。对于主要关注药物和器械治疗效果的定量研究,提出了四点建议。第一,确定样本中少数群体的代表性在哪些方面很重要——例如,种族可能导致不同治疗效果的情况。第二,如果特定群体的代表性很重要,那么通常有必要对结果进行亚组分析。第三,确保代表性和亚组分析会产生成本;决定这种代表性是否值得将涉及成本效益分析。第四,少数群体的代表性不应主要被视为一个地区性问题。对于定性研究,有人认为多样性的代表性通常很重要。然而,鉴于许多定性项目的样本量较小,确保代表性的最佳方法是允许此类研究大量开展,而不是在样本中规定这种代表性。