Bellows Brandon K, Biskupiak Joseph
Pharmacotherapy Outcomes Research Center, University of Utah, 421 Wakara Way, Salt Lake City, UT 84108, USA.
J Pain Palliat Care Pharmacother. 2011;25(3):267-74. doi: 10.3109/15360288.2011.599482.
The prevalence and costs of pain in the United States and throughout the world are high. This demonstrates the importance and need for comparative effectiveness research in pain. Comparative effectiveness research has been defined by the Institute of Medicine as evidence that compares the benefits and harms of treatment alternatives. Decision makers and consumers alike need comparative effectiveness data to aid in the decision making process. However, comparative effectiveness research presents many challenges and, in pain, has primarily been conducted in randomized controlled trials. These trials have some limitations that may prevent the application to the general population. Real world studies complement the information from randomized trials, but contain their own challenges and limitations. The International Society of Pharmacoeconomics and Outcomes Research has provided guidelines for the use of real world studies in comparative effectiveness research. The purpose of this article is to describe and address some the key methodological challenges of comparative effectiveness research, especially in pain.
在美国乃至全世界，疼痛的患病率和成本都很高。这表明了疼痛领域比较效果研究的重要性和必要性。医学研究所将比较效果研究定义为比较治疗方案的益处和危害的证据。决策者和消费者都需要比较效果数据来辅助决策过程。然而，比较效果研究面临诸多挑战，在疼痛领域，主要是在随机对照试验中进行的。这些试验存在一些局限性，可能会妨碍其应用于普通人群。真实世界研究补充了随机试验的信息，但也有自身的挑战和局限性。国际药物经济学与成果研究协会为在比较效果研究中使用真实世界研究提供了指导方针。本文旨在描述和解决比较效果研究，尤其是疼痛领域比较效果研究的一些关键方法学挑战。
