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首页> 外文期刊>Palliative medicine >Qualitative research in evidence-based medicine: improving decision-making and participation in randomized controlled trials of cancer treatments.
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Qualitative research in evidence-based medicine: improving decision-making and participation in randomized controlled trials of cancer treatments.

机译:循证医学的定性研究:改善决策制定和参与癌症治疗的随机对照试验。

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摘要

BACKGROUND: Since the 1990s there has been increasing emphasis on 'evidence-based medicine'. The randomized controlled trial is widely regarded as the 'gold-standard' study design for evaluating interventions. However, placing too strong an emphasis on a phase III trial, to the neglect of earlier development and piloting work, may result in weaker interventions that are more difficult to evaluate and less likely to be implemented. AIM: To illustrate the benefits and outcomes of qualitative research at the early stages of the research continuum. SETTING/PARTICIPANTS: Two cancer studies are evaluated in which the best treatment option is uncertain: ASPECTS (A Study of Patients ExperienCes of TreatmentS) and ProtecT (Prostate Testing for Cancer and Treatment). DESIGN: To examine decision-making in relation to palliative chemotherapy for advanced cancer, ASPECTS was a qualitative study involving non-participant observation and recording of oncology consultations. During the ProtecT feasibility study, recruitment interviews were routinely audiotaped and in-depth interviews conducted with men to explore their understanding of treatment options and randomization to trial arms. RESULTS: ASPECTS identified that insufficient information was given to patients about the survival benefits of palliative chemotherapy with implications for informed consent. ProtecT illustrated the effective use of qualitative research methods to resolve recruitment and randomization problems for a randomized controlled trial. CONCLUSIONS: These studies illustrate the value of qualitative research, particularly during the earlier phases of the research continuum. Such research may generate hypotheses, strengthen the development and implementation of interventions and enhance their evaluation: all of which are essential to evidence-based medicine.
机译:背景:自1990年代以来,人们越来越重视“循证医学”。随机对照试验被广泛认为是评估干预措施的“黄金标准”研究设计。但是,过分强调早期的发展和试点工作却忽视了三阶段试验,可能会导致干预措施较弱,难以评估,难以实施。目的:说明定性研究在研究过程的早期阶段的好处和结果。设置/参与者:对两项癌症研究进行了评估,其中最佳治疗方案尚不确定:ASPECTS(一项对患者的治疗经验研究)和ProtecT(一项针对癌症和治疗的前列腺测试)。设计:为了检查与晚期癌症姑息化疗相关的决策,ASPECTS是一项定性研究,涉及非参与者观察和肿瘤学咨询记录。在ProtecT可行性研究期间,定期对招聘面试进行录音,并与男性进行深入访谈,以探讨他们对治疗方案的了解以及随机分配到试验组。结果:ASPECTS确认没有为患者提供有关姑息化疗对生存的益处的信息,这对知情同意具有影响。 ProtecT举例说明了定性研究方法的有效使用,以解决随机对照试验的招募和随机化问题。结论:这些研究说明了定性研究的价值,特别是在研究连续性的早期阶段。这样的研究可能会产生假设,加强干预措施的制定和实施并增强其评估:所有这些都是基于证据的医学必不可少的。

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