Pragmatic Comparative Effectiveness Trials and Learning Health Systems in Pain Medicine: Opportunities and Challenges.
Pragmatic Comparative Effectiveness Trials and Learning Health Systems in Pain Medicine: Opportunities and Challenges.
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DOI：
10.1016/j.anclin.2023.03.010
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发表时间：
2023-06-01
影响因子：
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通讯作者：
Mackey, Sean C
中科院分区：
文献类型：
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作者：
Salmasi, Vafi;Terkawi, Abdullah Sulieman;Mackey, Sean C
大型随机临床试验或临床试验汇总代表了最高水平的临床证据，因为它们最大限度地减少了不同来源的混杂因素和偏倚。当前的综述深入讨论了所面临的挑战以及我们可以用来克服这些障碍的方法，以定制疼痛医学实用有效性试验的新颖设计。作者描述了他们使用开源学习健康系统收集高质量证据并在繁忙的学术疼痛中心进行务实临床试验的经验。
Large randomized clinical trials or aggregates of clinical trials represent the highest levels of clinical evidence because they minimize different sources of confounding and bias. The current review provides an in-depth discussion of the challenges faced and methods we can use to overcome these obstacles to tailor novel designs of pragmatic effectiveness trials to pain medicine. The authors describe their experiences with an open-source learning health system to collect high-quality evidence and conduct pragmatic clinical trials within a busy academic pain center.