Carlson Linda E, Oberoi Devesh V, Qureshi Maryam, Subnis Utkarsh
1 Department of Oncology, Cumming School of Medicine, University of Calgary , Calgary, Canada .
2 Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary , Calgary, Canada .
J Altern Complement Med. 2018 Sep/Oct;24(9-10):926-932. doi: 10.1089/acm.2018.0208.
The aim of this study was to highlight features of pragmatic real-world integrative oncology research by applying the PRagmatic Explanatory Continuum Indicator Summary (PRECIS-2) criteria to an ongoing integrative oncology clinical trial. The ongoing trial is a preference-based randomized comparative effectiveness trial of mindfulness-based cancer recovery (MBCR) versus t'ai chi/qigong (TCQ) for cancer survivors (the Mindfulness and T'ai Chi for Cancer Health [MATCH] study). The primary outcome of the MATCH study is distress, and secondary outcomes are quality of life, sleep disturbance, and physical functioning. The clinical trial is being undertaken at tertiary care cancer centers across two sites in Canada: Calgary (AB) and Toronto (ON), with a sample of 600 cancer survivors who have finished all cancer treatments and are distressed.
The MATCH trial was scored on the explanatory-pragmatic continuum for each of the nine domains of the PRECIS-2 criteria on a scale of 1-5, and was rated as more explanatory than pragmatic, despite initial design efforts being more pragmatic. Areas that were least pragmatic were methods of recruitment, follow-up, and intervention delivery. The more pragmatic areas were setting, outcomes, and data analysis.
More efforts toward conducting pragmatic trials are needed in the field of integrative oncology, as cancer-care institutions and policy makers are looking for sustainable interventions within already established treatment models. The PRECIS-2 criteria can help researchers meet these goals in the planning stages of trial development.
本研究旨在通过将实用解释性连续体指标总结(PRECIS-2)标准应用于一项正在进行的综合肿瘤学临床试验,突出实用的真实世界综合肿瘤学研究的特征。正在进行的试验是一项基于偏好的随机对照有效性试验,比较正念癌症康复(MBCR)与太极拳/气功(TCQ)对癌症幸存者的效果(癌症健康的正念与太极拳[MATCH]研究)。MATCH研究的主要结局是痛苦,次要结局是生活质量、睡眠障碍和身体功能。该临床试验正在加拿大两个地点的三级癌症护理中心进行:卡尔加里(AB)和多伦多(ON),样本为600名完成所有癌症治疗且感到痛苦的癌症幸存者。
MATCH试验在PRECIS-2标准的九个领域中的每个领域,在解释性-实用性连续体上按1-5分进行评分,尽管最初的设计努力更偏向实用性,但该试验被评为解释性高于实用性。实用性最低的领域是招募方法、随访和干预实施。实用性较高的领域是研究环境、结局和数据分析。
在综合肿瘤学领域,需要做出更多努力来开展实用性试验,因为癌症护理机构和政策制定者正在已有的治疗模式中寻找可持续的干预措施。PRECIS-2标准可以帮助研究人员在试验开发的规划阶段实现这些目标。