缩小观察研究与随机对照试验之间的差距,预防阿尔茨海默病和痴呆症。

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Melinda C Power, Brittany C Engelman, Jingkai Wei, M Maria Glymour
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引用次数: 0

摘要

尽管观察性研究已经确定了阿尔茨海默病和相关痴呆症(ADRD)的可改变风险因素,但有关改变风险因素以预防 ADRD 的随机对照试验(RCT)结果却不一致或没有定论。这一发现表明,有必要改进观察性研究与随机对照试验之间的转化。然而,观察性研究的许多共同特点降低了它们与设计相关 RCT 的相关性。观察性研究通常在资格标准、研究人群、随访时间、治疗条件、结果和效果估计等方面与 RCT 不同。我们以降低血压预防 ADRD 为例,说明观察性研究与 RCT 之间需要更紧密的联系,讨论了在制定 RCT 时使用典型报告的观察性证据的障碍,并强调了可用于使观察性研究与临床试验设计更相关的方法。我们的结论是,观察性研究提出和回答的问题可以与临床试验设计更加相关,更好地利用观察性数据可以提高试验成功的可能性,或至少提高试验的确定性。尽管我们关注的重点是如何将 ADRD 风险因素的观察性研究更好地转化为 ADRD 预防的 RCT,但总体主题广泛适用于生物医学研究的许多领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Closing the Gap Between Observational Research and Randomized Controlled Trials for Prevention of Alzheimer Disease and Dementia.

Although observational studies have identified modifiable risk factors for Alzheimer disease and related dementias (ADRD), randomized controlled trials (RCTs) of risk factor modification for ADRD prevention have been inconsistent or inconclusive. This finding suggests a need to improve translation between observational studies and RCTs. However, many common features of observational studies reduce their relevance to designing related RCTs. Observational studies routinely differ from RCTs with respect to eligibility criteria, study population, length of follow-up, treatment conditions, outcomes, and effect estimates. Using the motivating example of blood pressure reduction for ADRD prevention, we illustrate the need for a tighter connection between observational studies and RCTs, discuss barriers to using typically reported observational evidence in developing RCTs, and highlight methods that may be used to make observational research more relevant to clinical trial design. We conclude that the questions asked and answered by observational research can be made more relevant to clinical trial design and that better use of observational data may increase the likelihood of successful, or at least definitive, trials. Although we focus on improving translation of observational studies on risk factors for ADRD to RCTs in ADRD prevention, the overarching themes are broadly applicable to many areas of biomedical research.

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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
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