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创建肩痛患者临床试验的核心结局集:一项研究方案。

Creation of a core outcome set for clinical trials of people with shoulder pain: a study protocol.

作者信息

Gagnier Joel J, Page Matthew J, Huang Hsiaomin, Verhagen Arianne P, Buchbinder Rachelle

机构信息

Department of Orthopaedic Surgery, University of Michigan, MedSport, 24 Frank Lloyd Wright Drive, Lobby A, Ann Arbor, MI, 48106, USA.

Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.

出版信息

Trials. 2017 Jul 20;18(1):336. doi: 10.1186/s13063-017-2054-9.

Abstract

BACKGROUND

The selection of appropriate outcomes or domains is crucial when designing clinical trials, to appreciate the effects of different interventions, pool results, and make valid comparisons between trials. If the findings are to influence policy and practice, then the chosen outcomes need to be relevant and important to key stakeholders, including patients and the public, healthcare professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. Recent reviews of the measurement properties of patient-reported outcome measures for shoulder disorders revealed a large selection of diverse measures, many with questionable validity, reliability, and responsiveness. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set (COS), which should be measured and reported in all trials of shoulder disorders. The purpose of the present project is to develop and disseminate a COS for clinical trials in shoulder disorders.

METHODS/DESIGN: The methods for the COS development will include 3 phases: (1) a comprehensive review of the core domains used in shoulder disorder trials; (2) an international Delphi study involving relevant stakeholders (patients, clinicians, scientists) to define which domains should be core; and (3) an international focus group informed by the evidence identified in phases 1 and 2, to determine which measurement instruments best measure the core domains and identification of any evidence gaps that require further empiric evidence.

DISCUSSION

The aim of the current proposal is to convene several meetings of international experts and patients to develop a COS for clinical trials of shoulder disorders and to develop an implementation strategy to ensure rapid uptake of the core set of outcomes in clinical trials. There would be an expectation that the core set of outcomes would always be collected and reported, but it would not preclude use of additional outcomes in a particular trial.

摘要

背景

在设计临床试验时,选择合适的结果或领域至关重要,这有助于了解不同干预措施的效果、汇总结果并在试验之间进行有效比较。如果研究结果要影响政策和实践,那么所选结果需要对关键利益相关者(包括患者和公众、医疗保健专业人员以及其他做出医疗保健决策的人员)具有相关性和重要性。人们越来越认识到,临床试验中所测量的结果未得到足够重视。最近对肩部疾病患者报告结局测量指标的测量特性进行的综述显示,有大量不同的测量指标可供选择,其中许多指标的有效性、可靠性和反应性存疑。这些问题可以通过开发和使用一套商定的标准化结果集(称为核心结局集,COS)来解决,所有肩部疾病试验都应测量并报告该结果集。本项目的目的是为肩部疾病的临床试验开发并推广一个COS。

方法/设计:COS开发方法将包括三个阶段:(1)全面回顾肩部疾病试验中使用的核心领域;(2)开展一项涉及相关利益相关者(患者、临床医生、科学家)的国际德尔菲研究,以确定哪些领域应作为核心领域;(3)开展一个国际焦点小组,依据在第1阶段和第2阶段确定的证据,确定哪些测量工具能最好地测量核心领域,并识别需要进一步实证证据的任何证据空白。

讨论

当前提议的目的是召集国际专家和患者召开几次会议,为肩部疾病的临床试验开发一个COS,并制定一项实施策略,以确保在临床试验中迅速采用核心结局集。预计将始终收集并报告核心结局集,但这并不排除在特定试验中使用其他结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/5520329/962f6b40cead/13063_2017_2054_Fig1_HTML.jpg

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