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观察性研究在为临床决策提供信息方面的未开发潜力:美国临床肿瘤学会研究声明。

Untapped Potential of Observational Research to Inform Clinical Decision Making: American Society of Clinical Oncology Research Statement.

机构信息

Kala Visvanathan, Johns Hopkins Bloomberg School of Public Health and Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD; Laura A. Levit and Clifford A. Hudis, American Society of Clinical Oncology, Alexandria, VA; Derek Raghavan, Carolinas HealthCare System, Charlotte, NC; Sandra Wong, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Amylou Dueck, Mayo Clinic, Rochester, MN; and Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA.

出版信息

J Clin Oncol. 2017 Jun 1;35(16):1845-1854. doi: 10.1200/JCO.2017.72.6414. Epub 2017 Mar 30.

Abstract

ASCO believes that high-quality observational studies can advance evidence-based practice for cancer care and are complementary to randomized controlled trials (RCTs). Observational studies can generate hypotheses by evaluating novel exposures or biomarkers and by revealing patterns of care and relationships that might not otherwise be discovered. Researchers can then test these hypotheses in RCTs. Observational studies can also answer or inform questions that either have not been or cannot be answered by RCTs. In addition, observational studies can be used for postmarketing surveillance of new cancer treatments, particularly in vulnerable populations. The incorporation of observational research as part of clinical decision making is consistent with the position of many leading institutions. ASCO identified five overarching recommendations to enhance the role of observational research in clinical decision making: (1) improve the quality of electronic health data available for research, (2) improve interoperability and the exchange of electronic health information, (3) ensure the use of rigorous observational research methodologies, (4) promote transparent reporting of observational research studies, and (5) protect patient privacy.

摘要

ASCO 认为高质量的观察性研究可以推进癌症护理的循证实践,并且与随机对照试验(RCT)相辅相成。观察性研究可以通过评估新的暴露或生物标志物,以及揭示可能无法发现的护理模式和关系来产生假设。然后,研究人员可以在 RCT 中检验这些假设。观察性研究还可以回答或提供 RCT 无法回答或尚未回答的问题。此外,观察性研究可用于新的癌症治疗方法的上市后监测,特别是在弱势群体中。将观察性研究纳入临床决策是许多领先机构的立场。ASCO 提出了五项总体建议,以增强观察性研究在临床决策中的作用:(1)提高可用于研究的电子健康数据的质量,(2)提高电子健康信息的互操作性和交换,(3)确保使用严格的观察性研究方法,(4)促进观察性研究报告的透明性,以及(5)保护患者隐私。

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