Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
Clin Transl Sci. 2012 Feb;5(1):48-55. doi: 10.1111/j.1752-8062.2011.00383.x. Epub 2012 Feb 23.
Current approaches to medical science generally have not resulted in rapid, robust integration into feasible, sustainable real world healthcare programs and policies. Implementation science risks falling short of expectations if it aligns with historical norms. Fundamentally different scientific approaches are needed to accelerate such integration.
We propose that the key goal of implementation science should be to study the development, spread and sustainability of broadly applicable and practical programs, treatments, guidelines, and policies that are contextually relevant and robust across diverse settings, delivery staff, and subgroups. We recommend key conceptual and methodological characteristics needed to accomplish these goals.
The methods to produce such advances should be rapid, rigorous, transparent, and contextually relevant. We recommend approaches that incorporate a systems perspective, investigate generalizability, are transparent, and employ practical measures and participatory approaches.
To produce different outcomes, we need to think and act differently. Implications of such an implementation science approach include fundamental changes that should be relevant to Clinical Translational Science Award investigators, comparative effectiveness researchers, those interested in pragmatic trials, grant funders, and community partners.
当前的医学科学方法通常未能快速、有效地融入可行的、可持续的现实世界医疗保健计划和政策中。如果实施科学与历史规范保持一致,它可能会达不到预期的效果。为了加速这种整合,需要采用从根本上不同的科学方法。
我们提出,实施科学的关键目标应该是研究广泛适用和实用的方案、治疗方法、指南和政策在不同背景下的发展、传播和可持续性,这些方案、治疗方法、指南和政策在不同环境、不同服务提供者和不同亚组中具有稳健性和相关性。我们建议为实现这些目标所需的关键概念和方法特征。
产生这些进展的方法应该是快速、严格、透明和与上下文相关的。我们建议采用系统视角的方法、研究可推广性、透明度以及实用措施和参与性方法。
为了产生不同的结果,我们需要以不同的方式思考和行动。这种实施科学方法的影响包括应该与临床转化科学奖研究人员、比较效果研究人员、对实用试验感兴趣的人员、资助者和社区合作伙伴相关的根本变化。