实用主义和观察性研究在卫生保健和公共卫生中的价值。

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
Pragmatic and Observational Research Pub Date : 2017-05-12 eCollection Date: 2017-01-01 DOI:10.2147/POR.S137701
Maxwell S Barnish, Steve Turner
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引用次数: 71

摘要

循证实践是卫生保健服务提供的重要组成部分。然而,有一种倾向,体现在诸如推荐等级、评估、发展和评估等工具中,主要关注研究设计的分类,而牺牲了对单个研究的优势和局限性的详细评估。随机对照试验(RCT),特别是经典的“解释性”RCT,在证据层次中具有特殊地位。然而,经典的随机对照试验有很大的局限性,最明显的是缺乏普遍性,这限制了它们在临床实践中的直接适用性。实用和观察研究可以为现实世界的适用性提供宝贵的视角。该证据可以更广泛地用于补充经典随机对照试验的理想条件结果,遵循三角测量原则。在这篇综述文章中,我们讨论了几种可用于此能力的实用和观察性研究。我们讨论了它们的特殊优势以及如何克服它们的局限性,并通过说明提供了现实生活中的例子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The value of pragmatic and observational studies in health care and public health.

Evidence-based practice is an important component of health care service delivery. However, there is a tendency, embodied in tools such as Grades of Recommendation, Assessment, Development, and Evaluation, to focus principally on the classification of study design, at the expense of a detailed assessment of the strengths and limitations of the individual study. Randomized controlled trials (RCTs), and in particular the classical "explanatory" RCT, have a privileged place in the hierarchy of evidence. However, classical RCTs have substantial limitations, most notably a lack of generalizability, which limit their direct applicability to clinical practice implementation. Pragmatic and observational studies can provide an invaluable perspective into real-world applicability. This evidence could be used more widely to complement ideal-condition results from classical RCTs, following the principle of triangulation. In this review article, we discuss several types of pragmatic and observational studies that could be used in this capacity. We discuss their particular strengths and how their limitations may be overcome and provide real-life examples by means of illustration.

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来源期刊
Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
自引率
0.00%
发文量
11
期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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