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构建中国研究中心儿科临床试验管理质量指标体系:一项改进的德尔菲-层次分析法研究

Developing a quality indicator system for pediatric clinical trials management of research centers in China: a modified Delphi-Analytic Hierarchy Process study.

作者信息

Liu Chang, Liu Yi, Xuan Bo, Qi Yuenan, Ou Ling, Zhang Jianmin

机构信息

Drug Clinical Trial Institution, Children's Hospital, Capital Institute of Pediatrics, No.2 Yabao Road, Beijing, 100020, China.

出版信息

BMC Pediatr. 2025 Mar 31;25(1):256. doi: 10.1186/s12887-025-05513-y.

Abstract

BACKGROUND

Pediatric clinical trials face many challenges that hinder the development of safe and effective pediatric drugs. Enhancing risk control and management quality of pediatric clinical trials in research centers is essential to address these challenges. While existing studies focus on risk management from the perspective of sponsors, research specifically addressing risk management strategies in research centers is limited. There is a lack of systematic exploration and expert consensus on risk-based management system of pediatric trials for institutions. This study seeks to fill this gap by developing a risk assessment index system designed to enhance the management quality of pediatric clinical trials in research centers. The system is built upon a theoretical framework that integrates insights from experts across various domains of pediatric clinical trials.

METHODS

The Delphi-analytic hierarchy process method was used for expert consultation to develop a risk assessment index system in pediatric clinical trials management of research centers. The questionnaire was distributed to 20 experts with extensive experience in pediatric clinical trials. These experts were selected from various regions and work units across China. Experts with more than 5 years of working experience and bachelor degree or above were included for consultation. The mean value, proportion of experts with full marks, and variation coefficient of important score and feasibility score of the indicators were applied to include the indexes. The analytic hierarchy process was used to investigate the weight of each indicator.

RESULTS

The consultation outcomes exhibited good response rate and credibility, the experts' positive coefficients were 100% and 95%, respectively, and the authoritative coefficients were 0.885 and 0.892. The final quality management indicator system for research centers consisted of four primary, sixteen secondary, and thirty-two tertiary indicators. Protocol design and subject protection accounted for the highest weight of 0.3741 and 0.3148 respectively in the index system, and next came process management and data collection of 0.1879 and 0.1232 in quality management of pediatric clinical trials.

CONCLUSIONS

This study develops a systematic expert consensus on a risk-based quality system tailored to the management of pediatric clinical trials in domestic research centers. The framework identifies critical risk indicators in the management process, providing a potential reference for quality control and internal audits within pediatric clinical trial research centers in China. However, further research is required to assess its practical implementation and adaptability to diverse trial conditions.

摘要

背景

儿科临床试验面临诸多挑战,阻碍了安全有效的儿科药物研发。提高研究中心儿科临床试验的风险控制和管理质量对于应对这些挑战至关重要。虽然现有研究从申办方角度关注风险管理,但专门针对研究中心风险管理策略的研究有限。对于机构儿科试验的基于风险的管理系统缺乏系统探索和专家共识。本研究旨在通过开发一个旨在提高研究中心儿科临床试验管理质量的风险评估指标体系来填补这一空白。该体系基于一个整合了儿科临床试验各个领域专家见解的理论框架构建。

方法

采用德尔菲 - 层次分析法进行专家咨询,以制定研究中心儿科临床试验管理中的风险评估指标体系。问卷分发给20位在儿科临床试验方面有丰富经验的专家。这些专家来自中国各地不同地区和工作单位。纳入工作经验超过5年且具有本科及以上学历的专家进行咨询。应用指标重要性得分和可行性得分的均值、满分专家比例以及变异系数来纳入指标。采用层次分析法研究各指标权重。

结果

咨询结果显示出良好的回复率和可信度,专家积极系数分别为100%和95%,权威系数分别为0.885和0.892。研究中心最终的质量管理指标体系由4个一级指标、16个二级指标和32个三级指标组成。方案设计和受试者保护在指标体系中的权重最高,分别为0.3741和0.3148,其次是儿科临床试验质量管理中的过程管理和数据收集,权重分别为0.1879和0.1232。

结论

本研究针对国内研究中心儿科临床试验管理制定了一个基于风险质量体系的系统专家共识。该框架确定了管理过程中的关键风险指标,为中国儿科临床试验研究中心的质量控制和内部审计提供了潜在参考。然而,需要进一步研究以评估其实际实施情况及其对不同试验条件的适应性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac03/11956244/4d375db738bf/12887_2025_5513_Fig1_HTML.jpg

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