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[临床干预研究中的患者安全]

[Patient safety in clinical intervention research].

作者信息

Brekelmans Cecile T M, Kenter Marcel J H, Bouter Lex M, Koëter Gerard H

机构信息

Centrale Commissie voor Mensgebonden Onderzoek, Den Haag, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2011;155:A2359.

Abstract

In clinical intervention research, the monitoring of patient safety is essential. In December 2009, a symposium on the role of the different parties involved was organised. Research starts with a robust protocol with a section dealing with interim decision-making and procedures for reporting during the research. After the approval by an accredited Ethics Committee, the responsibility for the patient safety primarily lies with the investigators and sponsor (in the case of investigator-initiated research generally the Institutional Board of Directors). In addition, the appointment of a Data and Safety Monitoring Committee (DSMC) has become more frequent during recent years. This committee monitors the safety of patients by means of evaluation of interim results and advises the sponsor accordingly. The decision process concerning premature ending is a clinical decision, which should not exclusively be based on exceeding a statistical limit. The focus of the DSMC should be on safety issues; only in exceptional cases should a trial be discontinued because of clear efficacy, or the lack of it.

摘要

在临床干预研究中,对患者安全的监测至关重要。2009年12月,组织了一次关于不同参与方作用的研讨会。研究始于一个完善的方案,其中有一部分涉及中期决策以及研究期间的报告程序。在获得认可的伦理委员会批准后,患者安全的责任主要在于研究者和申办者(在研究者发起的研究中,通常是机构董事会)。此外,近年来设立数据与安全监测委员会(DSMC)的情况越来越普遍。该委员会通过评估中期结果来监测患者安全,并据此向申办者提供建议。关于提前结束的决策过程是一个临床决策,不应仅仅基于超过某个统计界限。DSMC的重点应是安全问题;只有在特殊情况下,才应因明确的疗效或缺乏疗效而终止试验。

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