RCN Research Institute, School of Health & Social Studies University of Warwick, Coventry, UK.
Health Expect. 2010 Sep;13(3):312-22. doi: 10.1111/j.1369-7625.2010.00590.x. Epub 2010 Jun 23.
The concept of evidence has become firmly rooted in health care, with most importance placed on the outcome of research in clinical and economic spheres. Much less emphasis is placed on the patient's contribution to evidence which remains relatively vague, of low status and often difficult to integrate with other forms of knowledge.
This article proposes a concept of patient-based evidence, to complement clinical and economic forms of evidence, and demonstrates one way in which it has been operationalized. The PRIME project developed a patient evidence-base to capture the lived experience of individuals with myalgic encephalitis (ME) or chronic fatigue syndrome (CFS).
Interviews were performed with 40 individuals with ME/CFS who varied in a range of demographic characteristics, including age, gender, and how severely affected individuals were.
PRIME has developed a patient evidence-base which has an extensive array of experiences data to provide researchers, clinicians and others with an in-depth insight into the lived experience of ME/CFS that can be used and analysed. Data are grouped into a wide range of themes, which can be downloaded and used in a variety of ways as a source of evidence to enable understanding of the lived experience of ME/CFS and so contribute to the development of a more patient-focused research agenda in ME/CFS.
While patient-based evidence used in the PRIME Project provides a useful start, further work is required to develop this area conceptually and methodologically, particularly in relation to how patient-based evidence can be considered alongside clinical and economic evidence.
证据的概念在医疗保健领域已经根深蒂固,最重视的是临床和经济领域研究的结果。然而,患者对证据的贡献却相对模糊、地位较低,且往往难以与其他形式的知识相结合,这方面的重视程度要低得多。
本文提出了一种基于患者的证据概念,以补充临床和经济形式的证据,并展示了一种实现这一概念的方法。PRIME 项目开发了一个患者证据库,以捕捉肌痛性脑脊髓炎(ME)或慢性疲劳综合征(CFS)患者的生活体验。
对 40 名 ME/CFS 患者进行了访谈,这些患者在年龄、性别和受影响严重程度等方面存在差异。
PRIME 开发了一个患者证据库,其中包含广泛的体验数据,为研究人员、临床医生和其他人员提供了深入了解 ME/CFS 生活体验的机会,这些数据可被用于分析。数据被分为广泛的主题,可下载并以多种方式使用,作为证据来源,以帮助理解 ME/CFS 的生活体验,并为 ME/CFS 中更以患者为中心的研究议程的发展做出贡献。
虽然 PRIME 项目中使用的基于患者的证据提供了一个有用的起点,但需要进一步在概念和方法上发展这一领域,特别是如何将基于患者的证据与临床和经济证据一起考虑。