将实施科学融入临床研究,最大限度地提高公共卫生影响:呼吁在临床研究中报告和调整实施策略的使用与实施结果的一致性。

Integrating implementation science in clinical research to maximize public health impact: a call for the reporting and alignment of implementation strategy use with implementation outcomes in clinical research.

机构信息

Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.

Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Implement Sci. 2020 Nov 25;15(1):103. doi: 10.1186/s13012-020-01060-5.

Abstract

BACKGROUND

Although comprehensive reporting guidelines for implementation strategy use within implementation research exist, they are rarely used by clinical (i.e., efficacy and effectiveness) researchers. In this debate, we argue that the lack of comprehensive reporting of implementation strategy use and alignment of those strategies with implementation outcomes within clinical research is a missed opportunity to efficiently narrow research-to-practice gaps.

MAIN BODY

We review ways that comprehensively specifying implementation strategy use can advance science, including enhancing replicability of clinical trials and reducing the time from clinical research to public health impact. We then propose that revisions to frequently used reporting guidelines in clinical research (e.g., CONSORT, TIDieR) are needed, review current methods for reporting implementation strategy use (e.g., utilizing StaRI), provide pragmatic suggestions on how to both prospectively and retrospectively specify implementation strategy use and align these strategies with implementation outcomes within clinical research, and offer a case study of using these methods.

CONCLUSIONS

The approaches recommended in this article will not only contribute to shared knowledge and language among clinical and implementation researchers but also facilitate the replication of efficacy and effectiveness research. Ultimately, we hope to accelerate translation from clinical to implementation research in order to expedite improvements in public health.

摘要

背景

尽管实施策略的综合报告指南在实施研究中已经存在,但临床(即疗效和有效性)研究人员很少使用这些指南。在这场辩论中,我们认为,在临床研究中,缺乏对实施策略使用的全面报告,以及这些策略与实施结果的一致性,是缩小研究与实践差距的一个错失的机会。

正文

我们回顾了全面说明实施策略使用情况可以促进科学发展的方法,包括提高临床试验的可重复性和缩短从临床研究到公共卫生影响的时间。然后,我们提出需要对临床研究中常用的报告指南(如 CONSORT、TIDieR)进行修订,回顾当前报告实施策略使用情况的方法(如利用 StaRI),提供如何在临床研究中前瞻性和回顾性地具体说明实施策略使用情况并使这些策略与实施结果保持一致的实用建议,并提供一个使用这些方法的案例研究。

结论

本文中推荐的方法不仅将有助于临床和实施研究人员之间的知识和语言共享,还有助于复制疗效和有效性研究。最终,我们希望加速从临床研究到实施研究的转化,以加快公共卫生的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f3/7690013/7ac2d1b02283/13012_2020_1060_Fig1_HTML.jpg

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