Clinically meaningful benefit and real-world evidence in Alzheimer's disease research and care

IF 4.9 Q1 CLINICAL NEUROLOGY
Robert Perneczky, Lutz Froelich
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Abstract

In the realm of medical research, assessing novel therapies extends beyond statistical significance. The concept of meaningful benefits plays a pivotal role in determining the practical impact of interventions on patient outcomes. Clinical trials, which form the bedrock of evidence-based medicine, guide treatment decisions and shape health-care practices. While statistical significance remains a fundamental criterion, it falls short in fully evaluating the clinical relevance of therapeutic interventions. Clinically meaningful benefits focus on tangible improvements in patient health and well-being, transcending mere statistical thresholds. Key considerations include survival rates, symptom relief, functional status, and other patient-oriented outcomes. Determining meaningful benefits varies across diseases, patient populations, and available treatments. Balancing statistical rigor with clinical relevance is crucial. Overpowered trials may detect smaller differences than anticipated, necessitating careful interpretation. Researchers must view trial results through a patient-centric lens. Beyond survival, evaluating quality of life and side effects is equally relevant. Quantifying meaningful benefits involves metrics like numbers needed to treat and progression-free survival. Consistency across outcomes matters, as clinicians weigh gains in survival against improvements in quality of life. The pursuit of meaningful benefits elevates clinical trials from mere statistical exercises to patient-centered endeavors. Researchers, clinicians, and regulators must prioritize outcomes that genuinely matter to patients, ensuring that medical progress translates into meaningful improvements for them and their families.

Abstract Image

阿尔茨海默病研究和护理的临床有意义的益处和现实证据
在医学研究领域,评估新疗法超出了统计意义的范畴。在确定干预措施对患者预后的实际影响时,有意义的益处的概念起着关键作用。临床试验是循证医学的基石,它指导治疗决策,塑造保健实践。虽然统计显著性仍然是一个基本标准,但它不足以充分评估治疗干预措施的临床相关性。临床意义的益处侧重于患者健康和福祉的切实改善,而不仅仅是统计阈值。主要考虑因素包括生存率、症状缓解、功能状态和其他以患者为导向的结果。确定有意义的益处因疾病、患者群体和现有治疗方法而异。平衡统计严谨性与临床相关性至关重要。过度试验可能会发现比预期更小的差异,需要仔细解释。研究人员必须从以患者为中心的角度来看待试验结果。除了生存之外,评估生活质量和副作用也同样重要。量化有意义的益处包括治疗所需的数量和无进展生存期等指标。结果的一致性很重要,因为临床医生会权衡生存的增加和生活质量的改善。追求有意义的益处将临床试验从单纯的统计练习提升到以患者为中心的努力。研究人员、临床医生和监管机构必须优先考虑对患者真正重要的结果,确保医疗进步转化为对患者及其家人有意义的改善。
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来源期刊
CiteScore
10.10
自引率
2.10%
发文量
134
审稿时长
10 weeks
期刊介绍: Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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