PDF(Pubmed)
Abstract：
UNASSIGNED: Pragmatic trials often implement an intervention across a population of patients but require information unavailable at the population level that must be reported by a subset of patients. In this pragmatic clinical trial, we compared characteristics of seriously ill patients with those who completed a survey evaluating advance care planning across 3 academic health systems.
UNASSIGNED: A deliberate process including health system and external stakeholders and patients was used to design materials for and the approach to seriously ill patients. We developed a survey and conducted a multistep process to identify seriously ill primary care patients. We evaluated the relationships of age, gender, race and ethnicity, and vulnerability using the social vulnerability index in this population, and explored the representativeness of survey respondents compared with the underlying seriously ill population in terms of age, race and ethnicity, and vulnerability measured.
UNASSIGNED: About 5% (8707 patients) of the primary care population was classified as seriously ill, 5351 were mailed a survey and 1100 provided survey responses. Hispanic and Black patients were younger than White patients, and Black and Hispanic patients were more vulnerable than White and Asian patients and patients of other races. Representativeness was high across age and race and ethnicity, although White and Hispanic patients were more likely to respond than Black and Asian patients and patients of other races. Vulnerability in the surveyed sample was nearly identical to the population.
UNASSIGNED: A tailored survey and recruitment strategy yielded a representative sample of seriously ill, largely older, primary care respondents in the context of a pragmatic clinical trial.
UNASSIGNED: A deliberate process including health system and external stakeholders and patients was used to design materials for and the approach to seriously ill patients. We developed a survey and conducted a multistep process to identify seriously ill primary care patients. We evaluated the relationships of age, gender, race and ethnicity, and vulnerability using the social vulnerability index in this population, and explored the representativeness of survey respondents compared with the underlying seriously ill population in terms of age, race and ethnicity, and vulnerability measured.
UNASSIGNED: About 5% (8707 patients) of the primary care population was classified as seriously ill, 5351 were mailed a survey and 1100 provided survey responses. Hispanic and Black patients were younger than White patients, and Black and Hispanic patients were more vulnerable than White and Asian patients and patients of other races. Representativeness was high across age and race and ethnicity, although White and Hispanic patients were more likely to respond than Black and Asian patients and patients of other races. Vulnerability in the surveyed sample was nearly identical to the population.
UNASSIGNED: A tailored survey and recruitment strategy yielded a representative sample of seriously ill, largely older, primary care respondents in the context of a pragmatic clinical trial.
摘要：
■务实试验通常在患者人群中实施干预，但需要在人群水平上无法获得的信息，必须由一部分患者报告。在这个务实的临床试验中,我们比较了在3个学术卫生系统中完成评估预先护理计划的调查的重病患者的特征。
■使用包括卫生系统和外部利益相关者以及患者在内的深思熟虑的过程来设计重病患者的材料和方法。我们进行了一项调查，并进行了一个多步骤的过程来识别严重的初级保健患者。我们评估了年龄的关系，性别,种族和民族,和脆弱性，使用该人群的社会脆弱性指数，并探讨了调查受访者在年龄方面与基础重病人群相比的代表性，种族和民族,和衡量的脆弱性。
■初级保健人群中约有5％（8707名患者）被归类为重病，5351人邮寄了一份调查，1100人提供了调查答复。西班牙裔和黑人患者比白人患者年轻，黑人和西班牙裔患者比白人和亚洲患者以及其他种族的患者更容易受到伤害。不同年龄、种族和族裔的代表性很高，尽管白人和西班牙裔患者比黑人和亚裔患者以及其他种族患者更可能有反应。调查样本中的脆弱性与人群几乎相同。
■量身定制的调查和招聘策略产生了具有代表性的重病样本，很大程度上较老，务实临床试验背景下的初级保健受访者。
■使用包括卫生系统和外部利益相关者以及患者在内的深思熟虑的过程来设计重病患者的材料和方法。我们进行了一项调查，并进行了一个多步骤的过程来识别严重的初级保健患者。我们评估了年龄的关系，性别,种族和民族,和脆弱性，使用该人群的社会脆弱性指数，并探讨了调查受访者在年龄方面与基础重病人群相比的代表性，种族和民族,和衡量的脆弱性。
■初级保健人群中约有5％（8707名患者）被归类为重病，5351人邮寄了一份调查，1100人提供了调查答复。西班牙裔和黑人患者比白人患者年轻，黑人和西班牙裔患者比白人和亚洲患者以及其他种族的患者更容易受到伤害。不同年龄、种族和族裔的代表性很高，尽管白人和西班牙裔患者比黑人和亚裔患者以及其他种族患者更可能有反应。调查样本中的脆弱性与人群几乎相同。
■量身定制的调查和招聘策略产生了具有代表性的重病样本，很大程度上较老，务实临床试验背景下的初级保健受访者。
