Wallace Michael P, Moodie Erica E M
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
Pharmacoepidemiol Drug Saf. 2014 Jun;23(6):580-5. doi: 10.1002/pds.3606. Epub 2014 Apr 3.
Much of current pharmacological practice focuses on identifying the single 'best' treatment (or course of treatments) for a particular disease. Recently, however, focus has begun to shift towards a more patient-centric rather than disease-centric approach, where personal characteristics are used to identify the optimal treatment for an individual. Adaptive treatment strategies (also known as dynamic treatment regimes) are part of a rapidly expanding area of research whereby such personalized treatments can be identified. These methods can lead to improved results over standard 'one size fits all' approaches, as well as provide a route to formalizing a common practice of using ad hoc approaches when deciding or updating management plans. Here, we provide an introduction to adaptive treatment strategies, explaining their background, their purpose, and how they can be employed in practice.
当前的药理学实践大多聚焦于为特定疾病确定单一的“最佳”治疗方法(或一系列治疗方法)。然而,近来关注点已开始转向一种更以患者为中心而非以疾病为中心的方法,即利用个人特征来为个体确定最佳治疗方案。适应性治疗策略(也称为动态治疗方案)是一个迅速发展的研究领域的一部分,通过该领域可确定此类个性化治疗方案。这些方法相较于标准的“一刀切”方法能带来更好的效果,同时也为在决定或更新管理计划时使用临时方法这一常见做法的规范化提供了一条途径。在此,我们对适应性治疗策略进行介绍,解释其背景、目的以及在实践中如何应用。