群体的力量：比较访谈和群体概念映射以确定护理的患者重要结局。
The power of the group: comparison of interviews and group concept mapping for identifying patient-important outcomes of care.
机构信息
Department of Emergency Medicine, Thomas Jefferson University, 1025 Walnut St, Suite 300, Philadelphia, PA, 19107, USA.
College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
BMC Med Res Methodol. 2019 Jan 8;19(1):7. doi: 10.1186/s12874-018-0656-x.
BACKGROUND
Data are limited regarding how to effectively and efficiently identify patient priorities for research or clinical care. Our goal was to compare the comprehensiveness and efficiency of group concept mapping (GCM), a group participatory method, to interviews for identifying patient goals when seeking care.
METHODS
We engaged patients with moderately- to poorly-controlled diabetes mellitus in either GCM or an individual interview. The primary outcome was the comprehensiveness of GCM brainstorming (the first stage of GCM) as compared to interviews for eliciting patient-important outcomes (PIOs) related to seeking care. Secondary outcomes included 1) comprehensiveness of GCM brainstorming and interviews compared to a master list of PIOs and 2) efficiency of GCM brainstorming, the entire GCM process and interviews.
RESULTS
We engaged 89 interview participants and 52 GCM participants (across 3 iterations of GCM) to identify outcomes most important to patients when making decisions related to diabetes management. We identified 26 PIOs in interviews, 33 PIOs in the first GCM brainstorming session, and 38 PIOs across all three GCM brainstorming sessions. The initial GCM brainstorming session identified 77% (20/26) of interview PIOs, and all 3 GCM brainstorming sessions combined identified 88% (23/26). When comparing GCM brainstorming and interviews to the master list of PIOs, the initial GCM brainstorming sessions identified 80% (33/41), all 3 GCM brainstorming sessions identified 93% (38/41) and interviews identified 63% (26/41) of all PIOs. Compared to interviews, GCM brainstorming required less research team time, more patient time, and had a lowest cost. The entire GCM process still required less research team time than interviews, though required more patient time and had a higher cost than interviews.
CONCLUSIONS
GCM brainstorming is a powerful tool for effectively and efficiently identifying PIOs in certain scenarios, though it does not provide the breadth and depth of individual interviews or the higher level conceptual organization of the complete process of GCM. Selection of the optimal method for patient engagement should include consideration of multiple factors including depth of patient input desired, research team expertise, resources, and the population to be engaged.
TRIAL REGISTRATION
Registered on ClinicalTrials.gov , NCT02792777. Registration information submitted 6/2/2016, with the registration first posted on the ClinicalTrials.gov website 6/8/2016. Data collection began on 4/29/2016.
背景
关于如何有效地识别患者在研究或临床护理方面的重点，相关数据十分有限。我们的目标是比较群体概念映射（GCM）和个体访谈这两种方法，以确定在寻求医疗服务时，哪种方法能更全面、更高效地识别患者的目标。
方法
我们让病情处于中等至较差控制水平的糖尿病患者参与 GCM 或个体访谈。主要结果是 GCM 头脑风暴（GCM 的第一阶段）在识别与寻求医疗服务相关的患者重要结果（PIO）方面的全面性，与访谈进行比较。次要结果包括 1）GCM 头脑风暴和访谈与 PIO 主列表的全面性比较，2）GCM 头脑风暴、整个 GCM 过程和访谈的效率。
结果
我们共对 89 名访谈参与者和 52 名 GCM 参与者（共 3 轮 GCM）进行了调查，以确定患者在做出与糖尿病管理相关的决策时，最关注的结果。我们在访谈中确定了 26 个 PIO，在第一轮 GCM 头脑风暴中确定了 33 个 PIO，在所有三轮 GCM 头脑风暴中确定了 38 个 PIO。第一轮 GCM 头脑风暴识别了 77%（20/26）的访谈 PIO，所有三轮 GCM 头脑风暴共识别了 88%（23/26）。将 GCM 头脑风暴与访谈与 PIO 主列表进行比较，第一轮 GCM 头脑风暴识别了 80%（33/41），所有三轮 GCM 头脑风暴识别了 93%（38/41），访谈识别了 63%（26/41）。与访谈相比，GCM 头脑风暴需要更少的研究团队时间、更多的患者时间，且成本最低。整个 GCM 过程所需的研究团队时间仍少于访谈，但所需的患者时间和成本都高于访谈。
结论
GCM 头脑风暴是一种有效的工具，能够在某些情况下有效地识别 PIO，但它提供的广度和深度不如个体访谈，也不如 GCM 全过程的高层次概念组织。选择最适合患者参与的方法应考虑多个因素，包括所需的患者投入深度、研究团队的专业知识、资源以及要参与的人群。
临床试验注册
ClinicalTrials.gov 注册，NCT02792777。于 2016 年 6 月 2 日提交注册信息，注册信息于 2016 年 6 月 8 日首次在 ClinicalTrials.gov 网站上发布。数据收集于 2016 年 4 月 29 日开始。
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