Lee Daniel J, Avulova Svetlana, Conwill Ralph, Barocas Daniel A
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Urol Oncol. 2017 Sep;35(9):552-558. doi: 10.1016/j.urolonc.2017.07.002. Epub 2017 Jul 26.
There have been significant effort and financial support to engage patients in the design and execution of medical research. However, little is known about the relative benefits or potential impact of involving patients in research, most efficient practices and systems to enhance their involvement, and potential barriers and challenges that are involved with engaging patients. In this review, we will discuss the value of patient centered research, review the challenges that many of these studies faced, and highlight potential future opportunities to enhance patient involvement in urologic research.
An English-language literature search was performed in the electronic databases of Medline (PubMed), EMBASE, Web of Science, Google Scholar, the Cochrane Library, and on the Patient Centered Outcomes Research Institute (PCORI) website. Search items included "patient-centered research," "patient-reported outcomes" and "patient engagement" in various combinations. Although PCORI has funded almost 600 projects with $1.6 billion to improve patient centered research, the search revealed 3 studies of patient engagement in the development, management, and execution of urologic oncology research.
Patient engagement in the design and execution of medical research can help align research topics to match patient priorities, improve survey and data collection tools, increase patient recruitment and participation in studies, and improve accessibility and dissemination of clinically relevant results from medical research. However, engagement patients in research requires significant investment of time, financial support, and energy from the patients, stakeholders, and researchers to provide mutual benefit. In the three studies in urologic oncology that involved patients, the patients provided a significant impact on the structure of the studies and helped improve the ability of patients to apply the results from the research studies.
The benefits to involving patients in research to improve the access, understanding, and application of clinical evidence can be significant. Patient engagement in urologic oncology research is limited currently, but is expected to grow as the funding agencies incentivize the practice and the culture shifts toward a greater emphasis on patient centered outcomes.
为使患者参与医学研究的设计与实施,已付出了巨大努力并提供了资金支持。然而,对于患者参与研究的相对益处或潜在影响、提高患者参与度的最有效实践和系统,以及患者参与所涉及的潜在障碍和挑战,我们知之甚少。在本综述中,我们将讨论以患者为中心的研究的价值,回顾许多此类研究面临的挑战,并强调未来提高患者参与泌尿外科研究的潜在机会。
在Medline(PubMed)、EMBASE、科学网、谷歌学术、考克兰图书馆等电子数据库以及患者为中心的结果研究机构(PCORI)网站上进行了英文文献检索。检索词包括以各种组合形式出现的“以患者为中心的研究”“患者报告的结果”和“患者参与”。尽管PCORI已资助了近600个项目,金额达16亿美元,以改善以患者为中心的研究,但检索发现仅有3项关于患者参与泌尿外科肿瘤学研究的开发、管理和实施的研究。
患者参与医学研究的设计与实施有助于使研究主题与患者优先事项相匹配,改进调查和数据收集工具,增加患者招募和参与研究的人数,并提高医学研究临床相关结果的可及性和传播范围。然而,让患者参与研究需要患者、利益相关者和研究人员投入大量的时间、资金支持和精力,以实现互利。在三项涉及患者的泌尿外科肿瘤学研究中,患者对研究结构产生了重大影响,并有助于提高患者应用研究结果的能力。
让患者参与研究以改善临床证据的获取、理解和应用,其益处可能是巨大的。目前患者参与泌尿外科肿瘤学研究的程度有限,但随着资助机构鼓励这种做法,且文化氛围向更加强调以患者为中心的结果转变,预计患者参与度将会提高。