Pant Pai Nitika, Chiavegatti Tiago, Vijh Rohit, Karatzas Nicolaos, Daher Jana, Smallwood Megan, Wong Tom, Engel Nora
Department of Medicine, McGill University; †Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec; ‡Dalla Lana School of Public Health, University of Toronto, Canada; and §Department of Health, Ethics and Society, Research School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Point Care. 2017 Dec;16(4):141-150. doi: 10.1097/POC.0000000000000147. Epub 2017 Nov 14.
Pilot (feasibility) studies form a vast majority of diagnostic studies with point-of-care technologies but often lack use of clear measures/metrics and a consistent framework for reporting and evaluation. To fill this gap, we systematically reviewed data to () catalog feasibility measures/metrics and () propose a framework.
For the period January 2000 to March 2014, 2 reviewers searched 4 databases (MEDLINE, EMBASE, CINAHL, Scopus), retrieved 1441 citations, and abstracted data from 81 studies. We observed 2 major categories of measures, that is, implementation centered and patient centered, and 4 subcategories of measures, that is, feasibility, acceptability, preference, and patient experience. We defined and delineated metrics and measures for a feasibility framework. We documented impact measures for a comparison.
We observed heterogeneity in reporting of metrics as well as misclassification and misuse of metrics within measures. Although we observed poorly defined measures and metrics for feasibility, preference, and patient experience, in contrast, acceptability measure was the best defined. For example, within feasibility, metrics such as consent, completion, new infection, linkage rates, and turnaround times were misclassified and reported. Similarly, patient experience was variously reported as test convenience, comfort, pain, and/or satisfaction. In contrast, within impact measures, all the metrics were well documented, thus serving as a good baseline comparator. With our framework, we classified, delineated, and defined quantitative measures and metrics for feasibility.
Our framework, with its defined measures/metrics, could reduce misclassification and improve the overall quality of reporting for monitoring and evaluation of rapid point-of-care technology strategies and their context-driven optimization.
试点(可行性)研究构成了使用即时护理技术的绝大多数诊断研究,但往往缺乏明确的测量方法/指标以及用于报告和评估的一致框架。为填补这一空白,我们系统地回顾了数据,以()编目可行性测量方法/指标,并()提出一个框架。
在2000年1月至2014年3月期间,两名评审员检索了4个数据库(MEDLINE、EMBASE、CINAHL、Scopus),检索到1441条引文,并从81项研究中提取了数据。我们观察到两大类测量方法,即围绕实施的和围绕患者的,以及4个子类别的测量方法,即可行性、可接受性、偏好和患者体验。我们为可行性框架定义并划定了指标和测量方法。我们记录了用于比较的影响测量方法。
我们观察到指标报告存在异质性,以及测量方法中指标的错误分类和误用。虽然我们观察到可行性、偏好和患者体验的测量方法和指标定义不明确,但相比之下,可接受性测量方法定义得最好。例如,在可行性方面,诸如同意率、完成率(此处原文有误,completion应是完成率,不是新感染率)、新感染率、关联率和周转时间等指标被错误分类和报告。同样,患者体验被不同地报告为检测便利性、舒适度、疼痛和/或满意度。相比之下,在影响测量方法中,所有指标都有详细记录,因此可作为一个良好的基线比较标准。通过我们的框架,我们对可行性的定量测量方法和指标进行了分类、划定和定义。
我们的框架及其定义的测量方法/指标,可以减少错误分类,提高用于监测和评估快速即时护理技术策略及其基于背景的优化的报告的整体质量。