Improving the Efficiency and Impact of Clinical Research: A Game Changer for 21st Century Neonatology.
Improving the Efficiency and Impact of Clinical Research: A Game Changer for 21st Century Neonatology.
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提高临床研究的效率和影响：21 世纪新生儿学的游戏规则改变者。
作者：
Modi N
每个临床医生都意识到日常临床护理中存在的许多不确定性。这些导致结果的变化和不公平，并对患者的健康和安全构成危险。证据的产生仍然太慢，太昂贵，太多的机会，太临时，完全不够。现代技术可以推动更快、更有效的证据生成和调查结果的实施。然而，专业人士和公众的购买也需要成功;简而言之，一个新的概念框架，旨在有效地减少不确定性，高效地，并在临床实践中逐步需要。目前，减少实践不确定性的迫切需要的研究往往从未完成，或者以效率低下或缺乏影响的方式进行。其后果是病人护理质量差，医生“首先，不伤害”的基本职责被废除。如果研究质量高，进行迅速，成本合理，对研究者和参与者的负担最小，那么研究就是有效的。如果研究结果被纳入证据综合，并且强有力的结论被毫不拖延地付诸实践，研究就会产生影响。在这里，我将讨论如何利用现代思维和新技术来提高临床研究的效率和影响。
Every clinician is aware of the many uncertainties that exist in everyday clinical care. These contribute to variation and inequity in outcomes and pose dangers to patient wellbeing and safety. Evidence generation is still too slow, too expensive, too much left to chance, too ad hoc, and wholly inadequate. Modern technologies can drive faster, more efficient evidence generation and implementation of findings. However, professional and public buy-in are also needed for success; in short, a new conceptual framework aimed at reducing uncertainties effectively, efficiently, and incrementally in clinical practice is required. Currently, much-needed research to reduce practice uncertainties is often never done, or conducted in ways that are inefficient or lack impact. The consequence is poor patient care and abrogation of the cardinal duty of doctors to “first, do no harm.” Research is efficient if high quality, conducted rapidly, at reasonable cost, with minimal burden on investigators and participants. Research has impact if outcomes are incorporated into evidence syntheses, and robust conclusions are implemented into practice without delay. Here, I will discuss ways that build upon modern thinking and new technologies to improve the efficiency and impact of clinical research.