research design

研究设计
  • 文章类型: Journal Article
    尽管与单测量/横截面设计相比,纵向设计可以提供显着的优势,他们需要仔细注意研究基础设施和多个时间点样本之间的流失风险。
    使用2项研究的实例探索了用于设计和管理纵向研究的适当基础设施和保留样本的方法的策略,一项针对多发性硬化症患者的25年研究和对乳腺癌幸存者的10年纵向随访。
    关键战略(开发适当的基础设施,最小化参与者的成本,并最大化研究参与的回报)有助于解决这些纵向样本中减员的严重威胁。
    实施这些策略可以帮助减轻一些缺点,并利用纵向研究的优势来产生可靠的,有见地,和有影响力的结果。
    UNASSIGNED: While longitudinal designs can provide significant advantages compared to single measurement/cross sectional designs, they require careful attention to study infrastructure and the risk of attrition among the sample over multiple time points.
    UNASSIGNED: The strategies used to design and manage an appropriate infrastructure for a longitudinal study and approaches to retain samples are explored using examples from 2 studies, a 25-year study of persons living with multiple sclerosis and a 10-year longitudinal follow-up of breast cancer survivors.
    UNASSIGNED: Key strategies (developing appropriate infrastructure, minimizing costs to participants, and maximizing rewards of study participation) have helped address the serious threat of attrition in these longitudinal samples.
    UNASSIGNED: Implementation of these strategies can help mitigate some of the disadvantages and leverage the strengths of longitudinal research to produce reliable, insightful, and impactful outcomes.
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  • 文章类型: Journal Article
    背景:既往有妊娠相关心血管风险指标的女性,包括妊娠期糖尿病(GDM)和妊娠期高血压疾病(HDP),未来心血管疾病(CVD)的风险增加。尽管建议在产后早期开始进行CVD筛查和预防性护理,某些障碍限制了对此类服务的访问。我们计划对文献进行范围审查,以探索和总结有GDM和HDP病史的女性产后CVD预防服务的障碍和促进因素的证据。
    方法:此范围审查将根据Arksey和O'Malley\(2005)的方法框架和JoannaBriggs研究所指导进行系统范围审查,并将遵循政策和实践信息证据以及教育研究所的协调中心指南。审查结果将使用系统审查的首选报告项目和范围审查的荟萃分析扩展(PRISMA-ScR)清单进行报告。我们将搜索以下数据库:Medline,Embase和CINAHL。我们将对注册论文和论文进行灰色文献检索。纳入和排除标准将保持广泛。将包括以英语或法语发表的定性和定量研究,这些研究调查并报告了先前患有GDM和HDP的妇女对产后CVD筛查和预防性护理的障碍或促进者。个人,人际关系,组织,和系统级因素将被报告。定性结果将被叙述性地总结,定量结果将使用多源综合方法吸收到主题中。
    背景:这篇综述代表了渥太华健康科学网络研究伦理委员会(QI-184)审查的更大项目的一个目标。我们将通过开放获取出版物传播本次审查产生的知识,关于女性心血管健康的演讲/公共论坛,妇女心血管疾病预防论坛和社交媒体。我们还将在加拿大妇女心脏健康联盟的年会上介绍这项审查的结果。
    BACKGROUND: Women with previous pregnancy-related cardiovascular risk indicators, including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have an increased risk of future cardiovascular disease (CVD). Although CVD screening and preventive care beginning in the early postpartum period are recommended, certain barriers limit access to such services. We plan to conduct a scoping review of the literature to explore and summarise evidence on the barriers and facilitators of postpartum CVD preventive services in women with a history of GDM and HDP.
    METHODS: This scoping review will be conducted in line with the Arksey and O\'Malley\'s (2005) methodological framework and the Joanna Briggs Institute guidance for conducting a systematic scoping review and will follow the Evidence for Policy and Practice Information and the Coordinating Centre at the Institute of Education guidelines. The review results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We will search the following databases: Medline, Embase and CINAHL. We will conduct grey literature searches for registered dissertations and theses. Inclusion and exclusion criteria will be kept broad. Qualitative and quantitative studies published in English or French that investigated and reported percieved barriers or facilitators to postpartum CVD screening and preventive care among women with previous GDM and HDP will be included. Individual, interpersonal, organizational, and system level factors will be reported. Qualitative findings will be summarised narratively, and quantitative findings will be absorbed within the themes using the multisource synthesis method.
    BACKGROUND: This review represents one objective of a larger project that was reviewed by the Ottawa Health Sciences Network Research Ethics Board (QI-184). We will disseminate knowledge emanating from this review through open-access publication, presentation/public forums on women\'s cardiovascular health, women\'s CVD prevention forums and social media. We will also present the findings of this review at the annual meeting of the Canadian Women\'s Heart Health Alliance.
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  • 文章类型: Journal Article
    背景:确保放射肿瘤学患者的安全对于提供高质量的医疗保健至关重要。患者安全指标(PSIs)提供了一种识别机制,量化和评估风险和安全措施的有效性。然而,目前,德国没有专门为放射肿瘤学量身定制的PSIs。本研究旨在:(1)创建专门为放射肿瘤学设置设计的PSIs,(2)开发并在心理上验证用于评估德国放射肿瘤学设施安全性的仪器,以及(3)评估在常规临床实践中实施该仪器的可行性。最终确定的问卷将作为放射肿瘤科的自我评估工具,帮助他们评估他们在确保患者安全方面的功效,优先考虑安全干预措施,并随时间跟踪性能。
    方法:我们正在进行为期3年的工作,混合方法研究以实现我们的目标。对于PSI的识别,我们将对PubMed数据库进行全面审查,以及审查国家和国际准则和建议。为了完善初始指标集,我们将咨询专家,包括医生,医学物理学家,护士,管理人员和放射治疗师通过焦点小组。我们将采用Delphi研究进行最终共识和指标选择。此外,患者的观点将通过成立一个项目患者委员会来纳入,该委员会在整个项目阶段都会开会。我们将把确定的PSI重新制定成问卷项目。问卷的清晰度和可理解性将通过认知访谈得到验证,随后在来自德国放射肿瘤科的150多名参与者中进行心理测试。问卷的最终版本将在常规医疗机构中实施,我们将在半结构化访谈中采访个人用户,了解他们对问卷的体验。我们将召开随后的专家研讨会,讨论研究结果,并探索更广泛实施问卷的途径。最终的问卷将通过Web应用程序进行访问。我们在此将研究报告作为预结果报告。
    背景:本研究的伦理批准由汉堡伦理委员会批准(批准号:2023-101018-BO-ff)。该试验由ARO(ArbeitsgemeinschaftRadioonkologie/德国癌症协会放射肿瘤学工作组)注册,协议编号2023-03,在德国注册的临床试验编号为DRKS00034690。研究结果将发表在会议论文和演讲以及期刊论文中,重点是开放获取期刊。结果还将在第三阶段的执行讲习班期间传播,这将涉及不同的利益相关者群体。
    背景:DRKS00034690。
    BACKGROUND: Ensuring patient safety in radiation oncology is crucial for delivering high-quality healthcare. Patient safety indicators (PSIs) provide a mechanism for identifying, quantifying and evaluating risks and the effectiveness of safety measures. However, there is currently no specialised set of PSIs tailored for radiation oncology in Germany. This study seeks to: (1) create PSIs specifically designed for radiation oncology settings, (2) develop and psychometrically validate an instrument for assessing safety in German radiation oncology facilities and (3) evaluate the feasibility of implementing this instrument in routine clinical practice. The finalised questionnaire will serve as a self-assessment instrument for radiation oncology departments, aiding them in evaluating their efficacy in ensuring patient safety, prioritising safety interventions and tracking performance over time.
    METHODS: We are undertaking a 3-year, mixed methods study to address our objectives. For the identification of PSIs, we will conduct a comprehensive review on the PubMed database, along with reviewing national and international guidelines and recommendations. To refine the initial set of indicators, we will consult with experts, including physicians, medical physicists, nurses, administrators and radiation therapists through focus groups. We will employ a Delphi study for the final consensus and selection of indicators. Additionally, the perspectives of patients will be incorporated by formation of a project patient\'s committee which meets throughout the project phases. We will reformulate the identified PSIs into questionnaire items. The questionnaire\'s clarity and comprehensibility will be validated through cognitive interviews, followed by psychometric testing in a pilot group of over 150 participants from German radiation oncology departments. The final version of the questionnaire will then be implemented in routine healthcare settings and we will interview individual users about their experiences with the questionnaire in semistructured interviews. We will convene a subsequent expert workshop to discuss the study results and explore avenues for the questionnaire\'s broader implementation. The finalised questionnaire will be made accessible via a web app. We hereby present the study potocol as a pre-results report.
    BACKGROUND: Ethical approval for this study was granted by the Hamburg Ethics Committee (Approval Number: 2023-101018-BO-ff). This trial is registered by the ARO (Arbeitsgemeinschaft Radioonkologie /working group for radiation oncology of the German Cancer Society), protocol number 2023-03 and in the German register for clinical trials with the number DRKS00034690. Study results will be published in conference papers and talks as well as journal papers with focus on open access journals. The results will be also disseminated during the implementation workshop in phase III, which will involve a diverse group of stakeholders.
    BACKGROUND: DRKS00034690.
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  • 文章类型: Journal Article
    背景:由于COVID-19的爆发,学校不得不上网。随着大学简化面对面(F2F)教育,混合式教学和学习(BTL)可以持续提供教育。然而,向BTL的突然过渡给学生和教师带来了挑战,特别是对于需要动手实践经验的健康科学计划。一些研究通过学生的反馈和评估来评估F2F教学和学习环境。然而,需要更可靠和有效的自我报告问卷,侧重于学生体验BTL的感知和经验。这项研究将批判性地评估,根据健康科学大学生的心理测量学特性,比较和总结评估BTL的自我报告问卷的质量。
    方法:将使用系统综述和荟萃分析设计。本审查将遵循系统审查和荟萃分析方案的首选报告项目,并遵循基于概念的健康测量指标选择标准(COSMIN)标准化指南。将在13个数据库中搜索报告BTL自我报告问卷作为具有各自心理测量特性的评估工具的研究。两名独立审稿人将使用COSMIN偏见风险清单评估论文,相关问卷的心理测量特性的证据质量将使用修改后的建议评估等级评估,开发和评估方法。根据他们的心理测量特性,这些评估将全面总结并为BTL评估提供最合适的自我报告问卷的最佳建议。
    背景:菲律宾大学研究资助管理办公室免除了该研究方案的伦理审查评估(方案编号UPMREB2022-0259-EX),因为该研究不会收集个人数据。该研究方案已在PROSPERO注册。结果将通过同行评审的期刊和会议进行传播,以帮助健康教育领域的研究人员和专业人员谨慎选择有效的自我报告问卷来评估混合学习。CRD42022372362。
    BACKGROUND: Due to the COVID-19 outbreak, schools had to switch online. As universities ease face-to-face (F2F) schooling, blended teaching and learning (BTL) enables the continuous delivery of education. However, the sudden transition to BTL poses challenges for students and teachers, especially for health sciences programmes that require hands-on practical experience. Several studies have evaluated F2F teaching and learning contexts through student feedback and evaluations. However, there needs to be more reliable and valid self-report questionnaires that focus on the perceptions and experiences of students experiencing BTL. This study will critically appraise, compare and summarise the quality of self-report questionnaires evaluating BTL among health science university students based on their psychometric properties.
    METHODS: A systematic review and meta-analysis design will be used. This review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and follow the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) standardised guidelines. 13 databases will be searched for studies reporting BTL self-report questionnaires as evaluation tools with their respective psychometric properties. Two independent reviewers will appraise the paper using the COSMIN risk of bias checklist and the quality of evidence of the psychometric properties of the relevant questionnaires will be assessed using the modified Grading of Recommendations Assessment, Development and Evaluation approach. Based on their psychometric properties, these assessments will comprehensively summarise and present the best recommendations for the most appropriate self-report questionnaires for BTL evaluation.
    BACKGROUND: The University of the Philippines\' Research Grants Administration Office exempted this research protocol from ethics review evaluation (protocol number UPMREB 2022-0259-EX) since this study will not collect individual data. The research protocol was registered with PROSPERO. The results will be disseminated through peer-reviewed journals and conferences to aid researchers and professionals in the field of health education to prudently choose effective self-report questionnaires evaluating blended learning.CRD42022372362.
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  • 文章类型: Journal Article
    背景:在主动脉瓣置换术(AVR)期间避免小主动脉瓣环(SAA)患者的患者-假体不匹配(PPM)仍然是一个具有挑战性的手术问题。在可用的手术选择中,主动脉根部扩大(ARE)和无支架瓣膜植入(SVI)是两种最常用的治疗策略.本系统综述将根据这两种选择之间的比较研究来寻找优势证据。
    方法:本系统综述将包括1946年1月1日至2024年3月31日发表的所有相关文章,以及Medline(Ovid)提供的全文,Embase,Cochrane图书馆和WebofScience数据库,没有任何语言限制。将筛选比较ARE与SVI在小主动脉根部患者中用于AVR的手术结果的观察性研究和随机对照试验。研究将分为三组:第1组,用于报告SVI或其他组织瓣膜结局而未将其与ARE结局进行比较的研究;第2组,用于报告ARE结局而未将其与SVI结局进行比较的研究;第3组,用于将ARE结局与SVI结局进行比较的研究。每个研究的证据质量将根据牛津循证医学中心标准进行评估。
    背景:不需要道德批准,因为没有收集主要数据。研究结果将在科学会议上发表和/或在同行评审的科学期刊上报告。
    背景:PROSPERO,CRD42023383793。
    BACKGROUND: Avoiding patient-prosthesis mismatch (PPM) in patients with small aortic annulus (SAA) during aortic valve replacement (AVR) is still a challenging surgical problem. Among surgical options available, aortic root enlargement (ARE) and stentless valve implantation (SVI) are the two most commonly used strategies. This systematic review will be conducted searching for superiority evidence based on comparative studies between these two options.
    METHODS: This systematic review will include all relevant articles published from 1 January 1946 to 31 March 2024, with available full texts from Medline (Ovid), Embase, Cochrane Library and Web of Science databases, without any language restriction. Observational studies and randomised controlled trials comparing surgical results of ARE versus SVI for AVR in patients with small aortic root will be screened. Studies will be classified into three groups: group 1 for studies that reported SVI or other tissue valve outcomes without comparing them with ARE outcomes; group 2 for studies that reported ARE outcomes without comparing them with SVI outcomes; and group 3 for studies that compared ARE outcomes with SVI outcomes. The quality of the evidence of each study will be evaluated according to Oxford Centre for Evidence-Based Medicine criteria.
    BACKGROUND: Ethical approval is not required because no primary data are collected. The findings will be presented at scientific conferences and/or reported in a peer-reviewed scientific journal.
    BACKGROUND: PROSPERO, CRD42023383793.
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  • 文章类型: Journal Article
    背景:胰腺癌的早期发现是通过为患者提供治愈性治疗来降低死亡率的重要步骤。已对风险人群中的筛查策略以及通过不同的检测方法进行了经济评估。然而,尚未进行筛查研究的综合,以告知资源分配,以便在疾病区域内进行早期发现。因此,评估胰腺癌筛查成本效益和成本的研究应进行系统回顾.
    方法:将对报告胰腺癌筛查的成本效益或成本的经济学评价进行系统评价。电子数据库Medline,WebofScience和EconLit将不受地理或时间限制进行搜索。两名独立审核员将根据预定义的标准选择符合条件的研究。将使用综合卫生经济评估报告标准声明和经济评估清单中的偏差来评估研究质量。一个审阅者将提取相关数据,第二个审阅者将交叉检查与提取表的合规性。关键项目将包括筛选个体的特征,使用的筛查策略,和成本,健康影响和成本效益作为研究产出。审稿人之间的意见分歧将通过咨询第三位审稿人来解决。
    背景:本研究不需要伦理批准,因为不会收集原始数据。结果将通过在会议上的演讲和在同行评审的期刊上发表来传播。系统评价的结果将为未来胰腺筛查的经济评估提供信息,为医疗资源优先级的决策提供指导。
    CRD42023475348。
    BACKGROUND: The early detection of pancreatic cancer is an important step in reducing mortality by offering patients curative treatment. Screening strategies in risk populations and by means of different detection methods have been economically evaluated. However, a synthesis of screening studies to inform resource allocation towards early detection within the disease area has not been done. Therefore, studies evaluating the cost-effectiveness and costs of screening for pancreatic cancer should be systematically reviewed.
    METHODS: A systematic review of economic evaluations reporting the cost-effectiveness or costs of pancreatic cancer screening will be conducted. The electronic databases Medline, Web of Science and EconLit will be searched without geographical or time restrictions. Two independent reviewers will select eligible studies based on predefined criteria. The study quality will be assessed using the Consolidated Health Economic Evaluation Reporting Standards statement and the Bias in Economic Evaluation checklist. One reviewer will extract relevant data and a second reviewer will cross-check compliance with the extraction sheet. Key items will include characteristics of screened individuals, the screening strategies used, and costs, health effects and cost-effectiveness as study outputs. Differences of opinion between the reviewers will be solved by consulting a third reviewer.
    BACKGROUND: Ethics approval is not required for this study since no original data will be collected. The results will be disseminated through presentations at conferences and publication in a peer-reviewed journal. The results of the systematic review will inform future economic evaluations of pancreatic screening, which provide guidance for decision-making in healthcare resource prioritisation.
    UNASSIGNED: CRD42023475348.
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  • 文章类型: Journal Article
    背景:自闭症年轻人和/或患有注意力缺陷多动障碍(ADHD)的同时发生的精神健康状况在从儿童和青少年心理健康服务(CAMHS)过渡到成人心理健康服务(AMHS)时遇到重大挑战。然而,对于这个人群来说,这种服务过渡的障碍和促进者知之甚少。本范围审查旨在综合自闭症年轻人和/或多动症患者从CAMHS过渡到AMHS的障碍和推动者的现有证据。
    方法:将使用Arksey和O\'Malley的六步范围审查框架。系统审查和Meta分析扩展的首选报告项目范围审查清单将指导本审查的报告。Medline的电子数据库,PsycINFO,CINAHL,Scopus,将搜索ProQuestCentral和GoogleScholar以英语发布的相关文章,没有日期限制。Title,摘要和全文筛选将由两名独立审稿人完成。如果文章侧重于(1)患有自闭症谱系障碍和/或ADHD(人群)的青少年和/或年轻人(18-24岁)和(2)描述与相关的因素,则研究将有资格纳入从CAMHS到AMHS(背景)的服务或护理过渡(概念)(3)。研究质量将使用标准质量评估标准进行评估,以评估各种领域的主要研究论文。将使用Bronfenbrenner的社会生态模型作为组织和报告结果的框架来提取和合成描述能够或抑制从CAMHS到AMHS过渡的因素的数据。
    背景:不需要道德批准。调查结果将通过同行评审的出版物传播,并在会议上介绍。
    背景:https://doi.org/10.17605/OSF。IO/BZPQF。
    BACKGROUND: Autistic young people and/or those with attention deficit hyperactivity disorder (ADHD) who have co-occurring mental health conditions experience significant challenges when transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). However, barriers and facilitators to this service transition are poorly understood for this population. This scoping review aims to synthesise the available evidence on barriers and enablers to the transition from CAMHS to AMHS for autistic young people and/or those with ADHD.
    METHODS: Arksey and O\'Malley\'s six-step framework for scoping reviews will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist will guide the reporting of this review. Electronic databases of Medline, PsycINFO, CINAHL, Scopus, ProQuest Central and Google Scholar will be searched for relevant articles published in English with no date limitations. Title, abstract and full-text screening will be completed by two independent reviewers. Studies will be eligible for inclusion if the article focuses on (1) adolescents and/or young people (aged 18-24) with a primary diagnosis of autism spectrum disorder and/or ADHD (population) and (2) describes factors associated with service or care transitions (concept) (3) from CAMHS to AMHS (context). Study quality will be evaluated using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. Data describing the factors that enable or inhibit the transition from CAMHS to AMHS will be extracted and synthesised using the Bronfenbrenner\'s social ecological model as a framework for organising and reporting results.
    BACKGROUND: Ethics approval is not required. Findings will be disseminated via peer-reviewed publications and presented at conferences.
    BACKGROUND: https://doi.org/10.17605/OSF.IO/BZPQF.
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  • 文章类型: Journal Article
    在随机试验中使用电子同意(e-consent)有很好的实际理由,特别是在进行大规模临床试验以回答人群水平的健康研究问题时。然而,确定电子同意的伦理原因并不那么清楚,这取决于对电子同意在临床试验中使用时的含义及其伦理意义的正确理解。在这里,我们重点介绍了道德意义的四个特征,这些特征引起了与电子同意有关的一系列道德考虑,值得进一步重点研究。
    There are good practical reasons to use electronic consent (e-consent) in randomised trials, especially when conducting large-scale clinical trials to answer population-level health research questions. However, determining ethical reasons for e-consent is not so clear and depends on a proper understanding of what e-consent means when used in clinical trials and its ethical significance. Here we focus on four features of ethical significance which give rise to a range of ethical considerations relating to e-consent and merit further focused ethics research.
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    暂无摘要。
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  • 文章类型: Journal Article
    重症监护试验评估了干预措施对具有不同个人病史和疾病原因的患者的影响。通常在异质性临床综合征的保护伞下,如败血症或急性呼吸窘迫综合征。鉴于这种变化,对于具有不同特征的个体,治疗对结局的影响可能有所不同是合理的.然而,在随机对照试验中,疗效通常通过平均治疗效果(ATE)来评估,量化干预对研究人群结局的平均影响。重要的是,ATE可能会隐藏患者特征水平之间的治疗对临床结果的影响的变化,这可能会错误地得出这样的结论:当干预实际上可能使某些患者受益时,干预并不能整体起作用。在这次审查中,我们描述了评估治疗效果异质性(HTE)的方法学方法,包括专家派生的分组,数据驱动的分组,基线风险建模,治疗效果建模,和个体治疗规则估计。接下来,我们概述了如何将HTE分析的见解纳入临床试验的设计。最后,我们提出了一个研究议程,以推进该领域并将HTE方法带到床边。
    Critical care trials evaluate the effect of interventions in patients with diverse personal histories and causes of illness, often under the umbrella of heterogeneous clinical syndromes, such as sepsis or acute respiratory distress syndrome. Given this variation, it is reasonable to expect that the effect of treatment on outcomes may differ for individuals with variable characteristics. However, in randomized controlled trials, efficacy is typically assessed by the average treatment effect (ATE), which quantifies the average effect of the intervention on the outcome in the study population. Importantly, the ATE may hide variations of the treatment\'s effect on a clinical outcome across levels of patient characteristics, which may erroneously lead to the conclusion that an intervention does not work overall when it may in fact benefit certain patients. In this review, we describe methodological approaches for assessing heterogeneity of treatment effect (HTE), including expert-derived subgrouping, data-driven subgrouping, baseline risk modeling, treatment effect modeling, and individual treatment rule estimation. Next, we outline how insights from HTE analyses can be incorporated into the design of clinical trials. Finally, we propose a research agenda for advancing the field and bringing HTE approaches to the bedside.
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