Howie Lynn, Hirsch Bradford, Locklear Tracie, Abernethy Amy P
Lynn Howie is a fellow in medical oncology at Duke University, in Durham, North Carolina.
Bradford Hirsch is an assistant professor in the Center for Learning Health Care, Duke Clinical Research Institute, in Durham.
Health Aff (Millwood). 2014 Jul;33(7):1220-8. doi: 10.1377/hlthaff.2014.0225.
The goal of comparative effectiveness research is to assess medical therapies and allow patients, health care providers, payers, and policy makers to make evidence-based decisions about the most appropriate therapies in routine clinical practice. To conduct this type of research and to inform health care delivery, data about the impact of interventions on patient outcomes are needed. Methods of generating evidence for comparative effectiveness research provide opportunities to engage patients and understand their experiences with illness and its treatment. In this article we assess the need for, uses of, and strengths and weaknesses of patient-generated data. We also review in brief federal and medical society efforts to create new streams of patient-generated data for clinical and research use. We observe that the key to high-quality patient-generated data is to have immediate and actionable data so that patients experience the importance of the data for their own care as well as research purposes. We conclude that leveraging the emerging wealth of "big data" being generated by patient-facing technologies such as systems to collect patient-reported outcomes data and patient-worn sensors is critical to developing the evidence base that informs decisions made by patients, providers, and policy makers in pursuit of high-value medical care.
比较效果研究的目标是评估医学疗法,并让患者、医疗服务提供者、支付方和政策制定者能够在常规临床实践中基于证据,就最合适的疗法做出决策。为开展此类研究并为医疗服务提供信息,需要有关干预措施对患者结局影响的数据。生成比较效果研究证据的方法为让患者参与并了解他们的疾病经历及其治疗体验提供了机会。在本文中,我们评估了患者生成数据的必要性、用途以及优缺点。我们还简要回顾了联邦政府和医学协会为创建用于临床和研究的患者生成数据新来源所做的努力。我们发现,高质量患者生成数据的关键在于拥有即时且可付诸行动的数据,以便患者体会到这些数据对自身护理以及研究目的的重要性。我们得出结论,利用患者报告结局数据收集系统和患者佩戴式传感器等面向患者的技术所产生的大量新兴“大数据”,对于建立证据基础至关重要,该证据基础可为患者、医疗服务提供者和政策制定者在追求高价值医疗服务时所做的决策提供依据。