Invited commentary: every good randomization deserves observation.
Invited commentary: every good randomization deserves observation.
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特邀评论：每一个好的随机化都值得观察。
DOI：
10.1093/aje/kwv200
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发表时间：
2015
影响因子：
5
通讯作者：
Edwards,JessieK
中科院分区：
文献类型：
--
作者：
Westreich,Daniel;Edwards,JessieK
暴露前预防（PrEP）是预防人类免疫缺陷病毒（HIV）传播的一种有前途的方法，其中HIV阴性个体每天服用单剂量的抗逆转录病毒药物，以便如果暴露于HIV，则活性抗逆转录病毒药物已经存在于他或她的系统中。在本期杂志中，Murnane等人（Am J Epidemiol. 2015;182（10）：848-856）使用来自合作伙伴PrEP研究（肯尼亚和乌干达，2008-2011）的数据来估计PrEP在完全依从性下的疗效。我们讨论Murnane等人。的工作，然后检查更大的问题的普遍性或运输的结果从随机试验到一个新的设置时，坚持干预决定其有效性。我们讨论了可推广性的充分条件，并使用因果有向无环图来展示当试验用于推断PrEP在当前和未来现实世界目标人群中的作用时，这些假设可能会如何发挥作用。
Preexposure prophylaxis (PrEP) is a promising approach to prevention of human immunodeficiency virus (HIV) transmission, in which an HIV-negative individual takes a single daily dose of an antiretroviral drug so that, if exposed to HIV, an active antiretroviral drug is already present in his or her system. In this issue of theJournal, Murnane et al. (Am J Epidemiol. 2015;182(10):848–856) use data from the Partners PrEP Study (Kenya and Uganda, 2008–2011) to estimate the efficacy of PrEP under perfect adherence. We discuss Murnane et al.'s work and then examine the larger issues of generalizability or transportability of findings from a randomized trial to a new setting when adherence to an intervention determines its effectiveness. We discuss sufficient conditions for generalizability and use causal directed acyclic graphs to show how these assumptions might play out when trials are used to make inferences about the effect of PrEP in current and future real-world target populations.