Chiappelli Francesco, Khakshooy Allen
Oral Biology & Medicine, Center for the Health Sciences UCLA; Health Sciences, California State University, Northridge; Evidence-Based Decisions Practice-Based Research Network (EBD-PBRN.org).
Oral Biology & Medicine, Center for the Health Sciences UCLA; Health Sciences, California State University, Northridge.
Bioinformation. 2016 Aug 15;12(5):263-265. doi: 10.6026/97320630012263. eCollection 2016.
Traditional research in the health sciences has involved control and experimental groups of patients, and descriptive and inferential statistical analyses performed on the measurements obtained from the samples in each group. As the novel model of translational healthcare, which integrates translational research and translational effectiveness, becomes increasingly established in modern contemporary medicine, healthcare continues to evolve into a model of care that is evidence-based, effectiveness-focused and patientcentered. Patient-centered care requires the timely and critical development and validation of a new research paradigm, which is referred to as "individual patient research (IPR)", as opposed as the customary group research approach. That is to say, research in geriatric disease conditions, such as Alzheimer's Disease (AD) must be performed from the viewpoint of individual patient research outcomes, and individual patient data analysis. Here, we discuss IPR in patients with AD in the context of the best available research evidence that indicates psychological symptoms, endocrine deregulation, and immune alterations in AD. We propose a clinical adaptive cluster randomized stepped wedge blinded controlled trial, with sequential with sequential roll-out of an evidence-based intervention in a crossover paradigm.
健康科学领域的传统研究涉及患者的对照组和实验组，并对从每组样本中获得的测量数据进行描述性和推断性统计分析。随着整合转化研究和转化有效性的新型转化医疗模式在现代当代医学中日益确立，医疗保健正不断演变成一种以证据为基础、以有效性为重点且以患者为中心的护理模式。以患者为中心的护理需要及时且关键地开发和验证一种新的研究范式，即“个体患者研究（IPR）”，这与传统的群体研究方法相对。也就是说，诸如阿尔茨海默病（AD）等老年疾病状况的研究必须从个体患者研究结果和个体患者数据分析的角度进行。在此，我们结合现有最佳研究证据来讨论AD患者的个体患者研究，这些证据表明AD存在心理症状、内分泌失调和免疫改变。我们提出一项临床适应性整群随机阶梯楔形盲法对照试验，采用交叉范式逐步推行基于证据的干预措施。
