Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and RCS Surgical Intervention Trial Unit, University of Oxford, Headington, Oxford, United Kingdom.
School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom.
Phys Ther. 2018 Feb 1;98(2):108-121. doi: 10.1093/ptj/pzx103.
The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care.
IDEAL 框架是一种用于对复杂医疗干预措施的创新和实践进行初始和持续评估的既定方法。最初为外科科学开发，并在全球范围内嵌入用于评估手术/手术器械，IDEAL 框架基于这样的原则，即临床实践中的创新和评估可以而且应该以有序的方式共同发展：从概念到开发，然后通过适当的临床研究进行验证，最后进行长期随访。该框架非常适合其他复杂的非药物干预措施，例如物理治疗干预。本文从该角度概述了将 IDEAL 应用于物理治疗的新 IDEAL-Physio 框架。IDEAL-Physio 框架包括 5 个阶段。在第 1 阶段，即理念阶段，应开始进行正式的数据收集。第 2a 阶段是进行迭代改进和调整并进行详细数据记录的阶段。第 2b 阶段涉及使用系统收集的群组或队列数据进行正式评估。第 3 阶段是正式比较治疗效果的阶段，通常涉及随机研究。第 4 阶段涉及长期随访。建议将 IDEAL-Physio 框架用作指导和评估物理治疗创新和实践的方法，总体目标是提供更好的基于证据的护理。
