Fineberg Iris Cohen, Grant Marcia, Aziz Noreen M, Payne Richard, Kagawa-Singer Marjorie, Dunn Geoffrey P, Kinzbrunner Barry M, Palos Guadalupe, Shinagawa Susan Matsuko, Krouse Robert S
International Observatory on End of Life Care, Institute of Health Research, Lancaster University, Lancaster, United Kingdom.
J Pain Symptom Manage. 2007 Jul;34(1 Suppl):S28-39. doi: 10.1016/j.jpainsymman.2007.04.009. Epub 2007 May 25.
In the setting of an international conference on malignant bowel obstruction as a model for randomized controlled trials (RCTs) in palliative care, we discuss the importance of incorporating prospective cultural considerations into research design. The approach commonly used in biomedical research has traditionally valued the RCT as the ultimate "way of knowing" about how to best treat a medical condition. The foremost limitation of this approach is the lack of recognition of the impact of cultural viewpoints on research outcomes. We propose that interest relevant to cultural viewpoints should be emphasized in conceptualizing and interpreting research questions, designs, and results. In addition to recognizing our cultural biases as individuals and researchers, we recommend two major shifts in designing and implementing RCTs: 1) inclusion of a multidisciplinary team of researchers to inform the diversity of perspectives and expertise brought to the research, and 2) use of mixed methods of inquiry, reflecting both deductive and inductive modes of inference.
在以恶性肠梗阻为姑息治疗随机对照试验（RCT）模型的国际会议背景下，我们讨论了将前瞻性文化因素纳入研究设计的重要性。生物医学研究中常用的方法传统上重视RCT，将其视为了解如何最佳治疗疾病的最终“认知方式”。这种方法的首要局限性在于缺乏对文化观点对研究结果影响的认识。我们建议在概念化和解释研究问题、设计及结果时应强调与文化观点相关的兴趣。除了认识到我们作为个体和研究人员的文化偏见外，我们还建议在设计和实施RCT时进行两个重大转变：1）纳入多学科研究团队，以体现研究中所带来的观点和专业知识的多样性；2）使用混合研究方法，反映演绎和归纳两种推理模式。
