Procome research group, Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, SE 171 77, Stockholm, Sweden.
Unit for Implementation and Evaluation, Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, SE 171 29, Stockholm, Sweden.
BMC Med Res Methodol. 2020 May 28;20(1):133. doi: 10.1186/s12874-020-00992-2.
Too often, studies of evidence-based interventions (EBIs) in preventive, community, and health care are not sufficiently useful to end users (typically practitioners, patients, policymakers, or other researchers). The ways in which intervention studies are conventionally conducted and reported mean that there is often a shortage of information when an EBI is used in practice. The paper aims to invite the research community to consider ways to optimize not only the trustworthiness but also the research's usefulness in intervention studies. This is done by proposing a typology that provides some approaches to useful EBIs for intervention researchers. The approaches originate from different research fields and are summarized to highlight their potential benefits from a usefulness perspective.
The typology consists of research approaches to increase the usefulness of EBIs by improving the reporting of four features in intervention studies: (1) the interventions themselves, including core components and appropriate adaptations; (2) strategies to support-high-quality implementation of the interventions; (3) generalizations about the evidence in a variety of contexts; and (4) outcomes based on end users' preferences and knowledge. The research approaches fall into three levels: Description, Analysis, and Design. The first level, Description, outlines what types of information about the intervention and its implementation, context, and outcomes can be helpful for end users. Research approaches under analysis offers alternative ways of analyzing data, increasing the precision of information provided to end users. Approaches summarized under design involve more radical changes and far-reaching implications for how research can provide more useful information. These approaches partly flip the order of efficacy and effectiveness, focusing not on whether an intervention works in highly controlled and optimal circumstances, but first and foremost whether an intervention can be implemented and lead to anticipated outcomes in everyday practice.
The research community, as well as the end users of research, are invited to consider ways to optimize research's usefulness as well as its trustworthiness. Many of the research approaches in the typology are not new, and their contributions to quality have been described for generations - but their contributions to useful knowledge need more attention.
在预防、社区和医疗保健领域，基于证据的干预措施（EBIs）的研究往往对最终用户（通常是从业者、患者、政策制定者或其他研究人员）没有足够的用处。干预研究的传统进行和报告方式意味着，当 EBI 在实践中使用时，通常会缺乏信息。本文旨在邀请研究界考虑如何不仅优化可信度，而且优化干预研究的研究有用性。这是通过提出一个分类法来实现的，该分类法为干预研究人员提供了一些有用的 EBI 方法。这些方法源自不同的研究领域，并进行了总结，以从有用性的角度突出它们的潜在益处。
该分类法包括通过提高干预研究中四个特征的报告来增加 EBIs 有用性的研究方法：（1）干预本身，包括核心组件和适当的调整；（2）支持高质量实施干预的策略；（3）在各种情况下对证据的概括；（4）基于最终用户偏好和知识的结果。研究方法分为三个层次：描述、分析和设计。第一个层次，描述，概述了有关干预措施及其实施、背景和结果的哪些类型的信息对最终用户有帮助。分析下的研究方法提供了分析数据的替代方法，增加了向最终用户提供的信息的准确性。设计下总结的方法涉及更激进的变化和对研究如何提供更有用信息的深远影响。这些方法部分颠覆了疗效和有效性的顺序，不是关注干预措施在高度控制和最佳情况下是否有效，而是首先关注干预措施是否可以在日常实践中实施并导致预期结果。
邀请研究界以及研究的最终用户考虑优化研究的有用性及其可信度。分类法中的许多研究方法并不新鲜，它们对质量的贡献已经被描述了几代人——但它们对有用知识的贡献需要更多的关注。
