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关于饮食失调研究的生活体验视角:适应性试验的使用和研究重点。

Lived experience perspectives on eating disorder research: The use of adaptive trials and research priorities.

机构信息

Flinders University Institute of Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia.

Blackbird Initiative, Flinders University, Adelaide, South Australia, Australia.

出版信息

Int J Eat Disord. 2024 Jun;57(6):1390-1398. doi: 10.1002/eat.24167. Epub 2024 Feb 16.

Abstract

OBJECTIVE

This novel study sought to understand lived experience and carer perspectives on the use of adaptive trials to evaluate interventions for eating disorders, in addition to understanding the factors and outcomes of most importance in eating disorder research and treatments from a lived experience perspective.

METHOD

A total of 73 people with either lived or carer experience consented, 70 started the questionnaire, and 36 (51%) completed all questions. Participants were asked Likert scale and open-ended questions to understand what factors and outcomes of eating disorder interventions were most important to them and understand their pre-existing knowledge of clinical trials. Two videos were then used to explain randomized controlled trials (RCTs) and adaptive trials and participants were asked their opinions, including perceived benefits and concerns, of each trial type.

RESULTS

The thematic analysis found two key themes regarding factors important in eating disorder treatment: Person-centred care and Evidence-based and effective treatment; and two key themes regarding outcomes of treatment: Sustained, full recovery and The bigger picture. Both RCTs and adaptive trials were viewed favorably, however, there was a slight preference for adaptive trials. Key themes for both demonstrated perceived benefits and ethical, practical, and scientific considerations unique to each.

DISCUSSION

Findings demonstrate the support of adaptive trials in eating disorder interventions from people with lived experience and their carers. It is recommended that researchers consider the use of adaptive designs and the incorporation of lived experience perspectives when designing future intervention trials.

PUBLIC SIGNIFICANCE

This novel study found that the use of adaptive trials in eating disorder intervention research is supported by people with lived experience and carers. Furthermore, the factors and outcomes of most importance to participants in this study are comparable to those previously identified in the emerging literature. The use of adaptive designs and the incorporation of lived experience are recommended in further clinical trials.

摘要

目的

本研究旨在从实际经验的角度了解适应性试验在评估进食障碍干预措施方面的应用,以及了解进食障碍研究和治疗中最重要的因素和结果,同时还了解照顾者对使用适应性试验评估进食障碍干预措施的实际经验和看法。

方法

共有 73 名有实际经验或照顾者经验的人同意参与,70 人开始填写问卷,36 人(51%)完成了所有问题。参与者被要求回答利克特量表和开放式问题,以了解他们认为对进食障碍干预措施最重要的因素和结果,以及他们对临床试验的预先了解。然后使用两个视频来解释随机对照试验(RCT)和适应性试验,并要求参与者对每种试验类型的看法,包括他们认为的好处和担忧。

结果

主题分析发现,两个关键主题与进食障碍治疗中重要的因素有关:以患者为中心的护理和基于证据的有效治疗;以及两个与治疗结果有关的关键主题:持续、完全康复和大局。RCT 和适应性试验都受到了好评,但适应性试验略受欢迎。两个主题都展示了对每种试验类型的独特好处和伦理、实际和科学方面的考虑。

讨论

研究结果表明,实际经验者及其照顾者支持在进食障碍干预中使用适应性试验。建议研究人员在设计未来的干预试验时考虑使用适应性设计,并纳入实际经验者的观点。

意义

这项新颖的研究发现,实际经验者和照顾者支持在进食障碍干预研究中使用适应性试验。此外,本研究参与者认为最重要的因素和结果与新兴文献中已经确定的因素和结果相似。建议在进一步的临床试验中使用适应性设计和纳入实际经验。

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