RAND Health, Santa Monica, CA, USA.
Implement Sci. 2011 Apr 4;6:36. doi: 10.1186/1748-5908-6-36.
The National Institutes of Health has called for expansion of practice-based research to improve the clinical research enterprise.
This paper presents a model for the reorganization of clinical research to foster long-term participation by community clinicians.Based on the literature and interviews with clinicians and other stakeholders, we posited a model, conducted further interviews to test the viability of the model, and further adapted it.
We propose a three-dimensional system of checks and balances to support community clinicians using research support organizations, community outreach, a web-based registry of clinicians and studies, web-based training services, quality audits, and a feedback mechanism for clinicians engaged in research.
The proposed model is designed to offer a systemic mechanism to address current barriers that prevent clinicians from participation in research. Transparent mechanisms to guarantee the safety of patients and the integrity of the research enterprise paired with efficiencies and economies of scale are maintained by centralizing some of the functions. Assigning other responsibilities to more local levels assures flexibility with respect to the size of the clinician networks and the changing needs of researchers.
美国国立卫生研究院呼吁扩大以实践为基础的研究，以改善临床研究事业。
本文提出了一种重组临床研究的模式，以促进社区临床医生的长期参与。基于文献和对临床医生和其他利益相关者的访谈，我们提出了一个模型，进行了进一步的访谈以测试模型的可行性，并进一步对其进行了调整。
我们提出了一个三维的制衡系统，通过研究支持组织、社区外展、临床医生和研究的基于网络的登记处、基于网络的培训服务、质量审计以及参与研究的临床医生的反馈机制来支持社区临床医生。
所提出的模型旨在提供一个系统机制，以解决当前阻碍临床医生参与研究的障碍。通过集中一些功能，保证患者安全和研究事业完整性的透明机制与效率和规模经济得以维持。将其他职责分配给更本地化的层次，确保了临床医生网络的规模和研究人员不断变化的需求的灵活性。
