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支持整合医学临床决策需要哪些研究?——比较效果研究能否缩小差距?

Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

机构信息

Charité University Medical Center, Institute for Social Medicine, Epidemiology and Health Economics, Berlin 10117, Germany.

出版信息

Chin J Integr Med. 2012 Oct;18(10):723-9. doi: 10.1007/s11655-012-1255-z. Epub 2012 Sep 11.

Abstract

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

摘要

在补充和整合医学的临床研究中,专家和科学家经常不顾终端用户需求的不完全了解而追求研究计划。因此,大多数先前的临床试验主要评估干预措施的疗效。关于其效果的数据很少。比较效果研究(CER)有望通过生成比较最佳护理方案的益处和危害的证据来支持决策者。这种证据比传统的随机对照试验(RCT)产生的证据更具普遍性,更适合为实际护理决策提供信息。对 CER 的重视支持了临床和政策决策的证据基础的发展。虽然在补充和整合医学的大多数领域,关于比较效果的数据都很匮乏,但现有的针灸研究已经为 CER 证据做出了贡献。本文将介绍 CER 并为未来的研究提出建议。

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