Zarin D A, Pincus H A, West J C, McIntyre J S
APA Office of Research, Washington, DC 20005, USA.
Am J Psychiatry. 1997 Sep;154(9):1199-208. doi: 10.1176/ajp.154.9.1199.
The authors describe the APA Practice Research Network (PRN), a national research initiative that ultimately will engage 1,000 practicing psychiatrists in collaborative clinical and services research. The PRN is designed to generate practice-relevant information and to inform future service delivery, policy, and financing decisions pertinent to psychiatry.
The authors review the relative strengths and limitations of practice-based research compared with other widely used research methods. They also describe the structure of the PRN and its procedures for recruiting network members and for identifying and developing specific network studies. The three primary sources of data for the PRN are 1) the biannual National Survey of Psychiatric Practice, which provides not only a mechanism for randomly recruiting the two-thirds of network participants who are not volunteers but also a baseline for assessing the generalizability of PRN findings; 2) separate biannual studies of psychiatric patients and treatments to characterize the network patient/treatment denominator, which is used to monitor trends in psychiatric practice and plan network studies; and 3) specific studies.
Pilot data from the PRN have yielded detailed information on the diagnostic and clinical characteristics of 725 patients and on the treatments provided by network psychiatrists.
The APA PRN offers a powerful complement to traditional clinical and health services research approaches. The PRN will help psychiatry improve its ability to meet patients needs in a context of rapidly evolving scientific and clinical progress and legislative and economic forces affecting health care delivery.
作者介绍了美国精神病学协会实践研究网络(PRN),这是一项全国性研究计划,最终将有1000名执业精神科医生参与协作临床和服务研究。PRN旨在生成与实践相关的信息,并为未来与精神病学相关的服务提供、政策和融资决策提供参考。
作者回顾了基于实践的研究与其他广泛使用的研究方法相比的相对优势和局限性。他们还描述了PRN的结构及其招募网络成员以及识别和开展特定网络研究的程序。PRN的三个主要数据来源是:1)每两年一次的全国精神病学实践调查,它不仅提供了一种随机招募三分之二非志愿者网络参与者的机制,还为评估PRN研究结果的普遍性提供了基线;2)对精神病患者和治疗的单独两年一次研究,以描述网络患者/治疗分母,用于监测精神病学实践趋势并规划网络研究;3)特定研究。
PRN的试点数据产生了有关725名患者的诊断和临床特征以及网络精神科医生提供的治疗的详细信息。
美国精神病学协会PRN为传统临床和卫生服务研究方法提供了有力补充。在科学和临床进展迅速以及影响医疗服务提供的立法和经济力量不断变化的背景下,PRN将有助于精神病学提高满足患者需求的能力。