Chalmers John, Woodward Mark, Borghi Claudio, Manolis Athanasios, Mancia Giuseppe
aThe George Institute for Global Health, University of Sydney, Sydney, Australia bThe George Institute for Global Health, University of Oxford, Oxford, UK cDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA dDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy eDepartment of Cardiology, Asklepeion Hospital, Athens, Greece fUniversity of Milano-Bicocca gCentre of Epidemiology and Clinical Trials, IRCSS Istituto Auxologico Italiano, Milan, Italy.
J Hypertens. 2016 Aug;34(8):1473-9. doi: 10.1097/HJH.0000000000000987.
Chronic diseases afflict patients for many years, often to the end of life, and there is increasing need for estimating lifelong risk and for evaluating the effects of treatment in the long term. Yet recommendations for lifelong treatment are most frequently based on findings from randomized clinical trials lasting only a few years. There is therefore a clear need for much longer term data, and here we present the advantages and disadvantages of many strategies, including the use of long-term posttrial follow-up, of long-term prospective cohort studies, registry databases, and of administrative databases. We also emphasize the need for long-term cost-effectiveness studies. One of the most promising strategies comes from linkage of data gathered through the ever-expanding pool of administrative databases worldwide with data from other sources, including randomized trials and the many forms of observational study.
慢性病折磨患者多年，常常直至生命终结，因此越来越需要评估终身风险并长期评估治疗效果。然而，终身治疗的建议大多基于仅持续数年的随机临床试验结果。所以，显然迫切需要更长期的数据，在此我们阐述多种策略的优缺点，包括长期试验后随访、长期前瞻性队列研究、登记数据库及行政数据库的使用。我们还强调了长期成本效益研究的必要性。最具前景的策略之一是将全球范围内不断扩充的行政数据库收集的数据与其他来源的数据（包括随机试验和多种形式的观察性研究数据）相链接。
