Benjaminy Shelly, Schepmyer Andrew, Illes Judy, Traboulsee Anthony
Neuroethics Canada, University of British Columbia, Vancouver, Canada.
Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Illinois, Canada.
BMC Health Serv Res. 2018 May 16;18(1):366. doi: 10.1186/s12913-018-3130-x.
Scientific and financial investments in chronic cerebrospinal venous insufficiency (CCSVI) research have been made to address both the hope for and scepticism over this interventional strategy for MS. Despite limited evidence in support of the CCSVI hypothesis, the funding of clinical research was responsive to a demand by the public rarely seen in the history of medicine. We characterize patient perspectives about the CCSVI research trajectory, with particular attention to its impact on other non-pharmaceutical areas of MS research with a focus on stem cell interventions.
Semi-structured interviews with 20 MS patients across Canada who did not have CCSVI interventions. Interviews were analysed for recurring themes and individual variations using the constant comparative approach.
Participants had a critical view of the divestment of funds from longstanding research to support CCSVI trials. They retain a sense of optimism, however, about emerging evidence for stem cell interventions for MS, and highlight the need for greater caution and conscientious communication of advances in medicine and science.
The unrealized hopes for CCSVI challenged but did not undermine the resilience of patient communities. The narrative that unfolded highlights the importance of drawing a socially-minded space for public participation in science.
针对慢性脑脊髓静脉功能不全(CCSVI)研究,已经进行了科学和资金投入,以应对人们对这种针对多发性硬化症的介入治疗策略的期望与怀疑。尽管支持CCSVI假说的证据有限,但临床研究的资金投入却回应了医学史上罕见的公众需求。我们描述了患者对CCSVI研究轨迹的看法,特别关注其对多发性硬化症研究中其他非药物领域的影响,重点是干细胞干预。
对加拿大20名未接受CCSVI干预的多发性硬化症患者进行半结构化访谈。采用持续比较法对访谈内容进行分析,以找出反复出现的主题和个体差异。
参与者对从长期研究中撤资以支持CCSVI试验持批评态度。然而,他们对多发性硬化症干细胞干预的新证据仍持乐观态度,并强调在医学和科学进展方面需要更加谨慎和认真地进行沟通。
CCSVI未实现的希望对患者群体的韧性构成了挑战,但并未将其削弱。所展现的情况凸显了为公众参与科学营造一个具有社会意识空间的重要性。