Morton Jacob B, McConeghy Robert, Heinrich Kirstin, Gatto Nicolle M, Caffrey Aisling R
University of Rhode Island, Department of Pharmacy Practice, College of Pharmacy, Kingston, RI, USA.
Veterans Affairs Medical Center, Infectious Diseases Research Program and Center of Innovation in Long Term Services and Supports, Providence, RI, USA.
Pharmacoepidemiol Drug Saf. 2016 Dec;25(12):1354-1360. doi: 10.1002/pds.4051. Epub 2016 Jun 30.
Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations.
We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap.
We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents.
We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd.
由于对高质量比较效果研究(CER)的需求不断增加,已发布了一些方法指导文件,例如医疗保健研究与质量局(AHRQ)和以患者为中心的结果研究所(PCORI)发布的文件。我们的目标是识别CER方法指导文件并对其进行比较,以总结重要建议,这些建议可作为CER方法建议的共识。
我们进行了系统的文献综述,以识别截至2014年发布的CER方法指导文件。对识别出的文件进行方法指导建议分析。对各个建议进行分类以确定重叠程度。
我们识别出九份方法指导文件,共包含312条建议,其中97%的建议出现在两份或更多文件中。所有九份文件都建议在结果的解释和传播中保持透明度并让相关利益相关者参与。其他经常共享的CER方法建议包括:研究设计和操作定义应事先制定并允许重复(n = 8份文件);关注当前临床知识中与决策者相关的空白领域(n = 7);应评估和讨论测量方法、工具和数据的有效性(n = 7);结果,包括益处和危害,应具有临床意义并进行客观测量(n = 7)。文件之间还普遍共享了关于评估和尽量减少偏倚(n = 6份文件)、混杂因素(n = 6)和异质性(n = 4)的建议及策略。
我们基于九份CER方法指导文件提供了一份领域共识指南,这将有助于研究人员设计CER研究并应用CER方法。版权所有© 2016约翰威立父子有限公司。