Von Korff M, Katon W, Lin E H, Wagner E H
Gen Hosp Psychiatry. 1987 Mar;9(2):118-25. doi: 10.1016/0163-8343(87)90023-5.
This article considers eight methodologic issues in the evaluation of psychiatric consultation-liaison services in primary care settings. What should be evaluated--standardized treatment regimens administered to highly selected patient groups or individualized treatments administered to heterogeneous patient groups? How can patient groups be selected to test for generic outcomes resulting from individualized treatments? When should randomized designs be employed? Should patients or physicians be randomized? How should diagnostic classification of study subjects be accomplished? What outcomes should be measured? How can study design be accommodated to patient flow in clinical settings? What resources are required to establish a productive program of research in liaison psychiatry?
本文探讨了基层医疗环境中精神科联络会诊服务评估的八个方法学问题。应该评估什么——针对高度特定患者群体实施的标准化治疗方案,还是针对异质性患者群体实施的个体化治疗?如何选择患者群体来测试个体化治疗产生的一般结果?何时应采用随机设计?应该对患者还是医生进行随机分组?研究对象的诊断分类应如何完成?应测量哪些结果?如何使研究设计适应临床环境中的患者流量?建立一个富有成效的联络精神病学研究项目需要哪些资源?