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患者及代理人对急诊研究社区咨询的看法。

Patient and Surrogate Views of Community Consultation for Emergency Research.

作者信息

Fehr Alexandra E, Scicluna Victoria M, Pentz Rebecca D, Haggins Adrianne N, Dickert Neal W

机构信息

Division of Cardiology, Atlanta, GA.

Department of Hematology and Medical Oncology, Winship Cancer Institute, Atlanta, GA.

出版信息

Acad Emerg Med. 2017 Nov;24(11):1410-1414. doi: 10.1111/acem.13265. Epub 2017 Oct 23.

Abstract

OBJECTIVE

Pretrial community consultation (CC) is required for emergency research conducted under an exception from informed consent (EFIC) in the United States. CC remains controversial and challenging, and minimal data exist regarding the views of individuals enrolled in EFIC trials on this process. It is important to know whether participants perceive CC to be meaningful and, if so, whom they believe should be consulted.

METHODS

We conducted a secondary analysis of data from two studies interviewing patients and surrogates of two recent EFIC trials (PEER-RAMPART and PEER-ProTECT). These interviews included similar open- and closed-ended questions regarding participants' views of the importance of CC, the rationale for their responses, and their views regarding which populations should be included in consultation efforts. A template analytic strategy was used for qualitative analysis of textual data, and descriptive statistics were tabulated to characterize demographic data and instances of major themes.

RESULTS

Ninety percent of participants perceived CC to be valuable. Participants' reasons for finding CC valuable clustered in two categories: 1) as a method of informing the public about the trial to be conducted and 2) as a way of obtaining input and feedback from the community. Participants cited the medical community (43%) and individuals with a connection to the study condition (41%) as the most important groups to involve in consultation efforts; only 5% suggested consulting the general public in the area where the research will be conducted.

CONCLUSION

Participants in EFIC trials and their decision makers generally valued CC as a method of informing and seeking input from the community. Participants felt that the most appropriate groups to consult were the medical community and individuals with connections to the condition under study. Consultation efforts focused on these two groups, rather than the general public, may be more efficient and more meaningful to individuals involved in EFIC trials. These findings also reinforce the importance of the distinction between public disclosure and CC.

摘要

目的

在美国,根据知情同意豁免(EFIC)进行的紧急研究需要进行审前社区咨询(CC)。CC仍然存在争议且具有挑战性,关于参与EFIC试验的个体对这一过程的看法的数据极少。了解参与者是否认为CC有意义,如果是,他们认为应该咨询哪些人,这一点很重要。

方法

我们对两项研究的数据进行了二次分析,这两项研究对两项近期EFIC试验(PEER - RAMPART和PEER - PROTECT)的患者及代理人进行了访谈。这些访谈包括了类似的开放式和封闭式问题,涉及参与者对CC重要性的看法、他们回答的理由,以及他们对哪些人群应纳入咨询工作的看法。采用模板分析策略对文本数据进行定性分析,并列表呈现描述性统计数据以刻画人口统计学数据及主要主题的实例。

结果

90%的参与者认为CC有价值。参与者认为CC有价值的原因集中在两类:1)作为一种向公众通报即将进行的试验的方式;2)作为一种从社区获取意见和反馈的途径。参与者指出,医学界(43%)和与研究疾病有关联的个人(41%)是参与咨询工作最重要的群体;只有5%的人建议咨询研究将开展地区的普通公众。

结论

EFIC试验的参与者及其决策者普遍认为CC是一种向社区通报情况并征求意见的方式。参与者认为最合适咨询的群体是医学界和与所研究疾病有关联的个人。针对这两个群体而非普通公众开展咨询工作,可能对参与EFIC试验的个体更高效且更有意义。这些发现也强化了公开披露与CC之间区别的重要性。

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