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单病例实验设计在康复干预效果评估中的应用:实用指南。

Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide.

机构信息

Institut universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; Service de chirurgie orthopédique infantile, hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg, France; GRC handicap cognitif et réadaptation (HanCRe), hôpitaux universitaires Pitié-Salpêtière, 75013 Paris, France.

Institute of Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, United Kingdom.

出版信息

Ann Phys Rehabil Med. 2018 May;61(3):164-179. doi: 10.1016/j.rehab.2017.12.002. Epub 2017 Dec 15.

Abstract

Single-case experimental designs (SCED) are experimental designs aiming at testing the effect of an intervention using a small number of patients (typically one to three), using repeated measurements, sequential (±randomized) introduction of an intervention and method-specific data analysis, including visual analysis and specific statistics. The aim of this paper is to familiarise professionals working in different fields of rehabilitation with SCEDs and provide practical advice on how to design and implement a SCED in clinical rehabilitation practice. Research questions suitable for SCEDs and the different types of SCEDs (e.g., alternating treatment designs, introduction/withdrawal designs and multiple baseline designs) are reviewed. Practical steps in preparing a SCED design are outlined. Examples from different rehabilitation domains are provided throughout the paper. Challenging issues such as the choice of the repeated measure, assessment of generalisation, randomization, procedural fidelity, replication and generalizability of findings are discussed. Simple rules and resources for data analysis are presented. The utility of SCEDs in physical and rehabilitation medicine (PRM) are discussed.

摘要

单病例实验设计(SCED)是一种旨在通过少量患者(通常为一到三名)进行重复测量,顺序(±随机)引入干预措施并采用特定方法进行数据分析,包括视觉分析和特定统计方法,来测试干预效果的实验设计。本文的目的是使从事康复不同领域的专业人员熟悉 SCED,并提供如何在临床康复实践中设计和实施 SCED 的实用建议。本文回顾了适合 SCED 的研究问题和不同类型的 SCED(例如,交替治疗设计、引入/撤出设计和多个基线设计)。概述了准备 SCED 设计的实际步骤。整篇文章都提供了来自不同康复领域的例子。讨论了一些具有挑战性的问题,如重复测量的选择、推广评估、随机化、程序一致性、复制和结果的可推广性。还介绍了简单的数据分析规则和资源。讨论了 SCED 在物理医学和康复医学(PRM)中的应用。

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