Resnik Linda, Klinger Shana
a Health Services, Policy and Practice , Brown University , Providence , RI , USA.
Disabil Rehabil Assist Technol. 2017 Nov;12(8):816-821. doi: 10.1080/17483107.2016.1269212. Epub 2017 Jan 18.
(1) Describe study attrition; (2) identify reasons for attrition, and (3) discuss implications for prosthetic prescription and design of future device studies. Design and methodological procedures used: Completion phase (during in-laboratory training, after training, or home use) was identified for 42 participants. Qualitative data were analyzed to identify attrition reasons. Reasons were classified as related to the DEKA arm, or not.
Study attrition was 57%, with 43% completing the full study. Attrition during the in-laboratory portion was 21%. Reasons for attrition were related to the DEKA arm entirely or in-part for 42%, 25%, respectively. Most common reasons were scheduling/personal (54%); device weight (29%); and dissatisfaction with device (25%). About 21% withdrew because of concerns about compliance with study protocol.
This study had a high attrition rate with evidence of selective attrition due to device characteristics. Strategies to minimize attrition and the importance of tracking reasons for withdrawal are discussed. Given that retention could be an indicator of willingness to adopt the DEKA arm, findings suggest that it would be prudent to provide patients with the opportunity to train with the DEKA arm before a decision is made regarding the appropriateness of the device for the patient. Implications for Rehabilitation This study of a new upper limb prosthesis, the DEKA arm, had a 57% attrition rate with evidence of selective attrition due to characteristics of the DEKA arm. Findings point to the need for strategies to minimize attrition in future studies. Findings also illustrate the importance of tracking reasons for subject withdrawal in longitudinal prosthesis device studies. Because participant retention in longitudinal device studies may be an indicator of future willingness to adopt a device, our findings suggest that it would be prudent to provide patients with the opportunity to train with the DEKA arm before a final decision is made regarding the appropriateness of the device for the patient.
（1）描述研究对象的流失情况；（2）确定流失原因；（3）讨论对假肢处方及未来设备研究设计的影响。所采用的设计和方法步骤：确定了42名参与者的完成阶段（实验室训练期间、训练后或在家使用期间）。对定性数据进行分析以确定流失原因。原因被分类为与DEKA手臂相关或无关。
研究对象流失率为57%，43%的人完成了整个研究。实验室阶段的流失率为21%。流失原因完全或部分与DEKA手臂相关的分别占42%、25%。最常见的原因是日程安排/个人原因（54%）；设备重量（29%）；以及对设备不满意（25%）。约21%的人因担心不符合研究方案而退出。
本研究流失率较高，有证据表明因设备特性导致选择性流失。讨论了将流失率降至最低的策略以及追踪退出原因的重要性。鉴于留存率可能是采用DEKA手臂意愿的一个指标，研究结果表明，在决定该设备是否适合患者之前，为患者提供使用DEKA手臂进行训练的机会是谨慎的做法。对康复的影响 这项关于新型上肢假肢DEKA手臂的研究流失率为57%，有证据表明因DEKA手臂的特性导致选择性流失。研究结果表明未来研究需要采取策略将流失率降至最低。研究结果还说明了在纵向假肢设备研究中追踪受试者退出原因的重要性。由于纵向设备研究中的参与者留存率可能是未来采用某设备意愿的一个指标，我们的研究结果表明，在最终决定该设备是否适合患者之前，为患者提供使用DEKA手臂进行训练的机会是谨慎的做法。
