Division of Hospital Medicine, Cincinnati Children's Hospital, Ohio; and Department of Pediatrics, University of Cincinnati, Ohio.
J Pediatric Infect Dis Soc. 2018 Dec 3;7(4):335-337. doi: 10.1093/jpids/pix082.
Each quality improvement (QI) project has an implicit study design, although these designs are not discussed as commonly as they are in clinical research. Most QI projects fall under the quasi-experimental study category, in which observations are made before and after the implementation of an intervention(s). The simplest and most commonly used for QI studies is the pre-post design, in which observations are made before and after each intervention that was implemented over a specified period. More sophisticated designs for QI studies enable a study team to draw stronger inferences about the system that is being changed and the individual effects of the interventions that are implemented. In the final commentary in this QI series, we discuss these study designs and focus on the strengths and weaknesses of more sophisticated designs, including cluster randomized, stepped-wedge, and factorial designs.
每个质量改进（QI）项目都有一个隐含的研究设计，尽管这些设计不像临床研究那样经常被讨论。大多数 QI 项目属于准实验研究类别，在这种研究中，在实施干预措施前后进行观察。QI 研究中最简单和最常用的是前后设计，其中在规定的时间段内对每次实施的干预措施前后进行观察。QI 研究中更复杂的设计使研究团队能够对正在改变的系统以及实施的干预措施的个体效果做出更有力的推断。在本 QI 系列的最后一篇评论中，我们讨论了这些研究设计，并重点介绍了更复杂设计的优缺点，包括集群随机、逐步楔形和析因设计。
