Peek C J, Glasgow Russell E, Stange Kurt C, Klesges Lisa M, Purcell E Peyton, Kessler Rodger S
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
Department of Family Medicine and Colorado Health Outcomes Program, University of Colorado, Denver, Colorado.
Ann Fam Med. 2014 Sep-Oct;12(5):447-55. doi: 10.1370/afm.1688.
Research often fails to find its way into practice or policy in a timely way, if at all. Given the current pressure and pace of health care change, many authors have recommended different approaches to make health care research more relevant and rapid. An emerging standard for research, the "5 R's" is a synthesis of recommendations for care delivery research that (1) is relevant to stakeholders; (2) is rapid and recursive in application; (3) redefines rigor; (4) reports on resources required; and (5) is replicable. Relevance flows from substantive ongoing participation by stakeholders. Rapidity and recursiveness occur through accelerated design and peer reviews followed by short learning/implementation cycles through which questions and answers evolve over time. Rigor is the disciplined conduct of shared learning within the specific changing situations in diverse settings. Resource reporting includes costs of interventions. Replicability involves designing for the factors that may affect subsequent implementation of an intervention or program in different contexts. These R's of the research process are mutually reinforcing and can be supported by training that fosters collaborative and reciprocal relationships among researchers, implementers, and other stakeholders. In sum, a standard is emerging for research that is both rigorous and relevant. Consistent and bold application will increase the value, timeliness, and applicability of the research enterprise.
研究往往难以及时应用于实践或政策之中，甚至根本无法做到这一点。鉴于当前医疗保健变革的压力和速度，许多作者推荐了不同的方法，以使医疗保健研究更具相关性且速度更快。一种新兴的研究标准——“5R原则”，是对护理交付研究建议的综合，即（1）与利益相关者相关；（2）在应用中快速且具有递归性；（3）重新定义严谨性；（4）报告所需资源；（5）具有可复制性。相关性源于利益相关者持续的实质性参与。快速性和递归性通过加速设计和同行评审实现，随后是短周期的学习/实施过程，在此过程中问题和答案会随着时间不断演变。严谨性是指在不同环境中特定变化情况下有纪律地进行共享学习。资源报告包括干预措施的成本。可复制性涉及针对可能影响干预措施或项目在不同背景下后续实施的因素进行设计。研究过程的这些“R原则”相互促进，并且可以通过培养研究人员、实施者和其他利益相关者之间协作与互惠关系的培训来加以支持。总之，一种既严谨又相关的研究标准正在形成。持续且大胆地应用将提高研究事业的价值、及时性和适用性。
