Assessing Treatment Fidelity within an Epilepsy Randomized Controlled Trial: Seizure First Aid Training for People with Epilepsy Who Visit Emergency Departments
Assessing Treatment Fidelity within an Epilepsy Randomized Controlled Trial: Seizure First Aid Training for People with Epilepsy Who Visit Emergency Departments
复制标题
评估癫痫随机对照试验中的治疗保真度：对到急诊科就诊的癫痫患者进行癫痫急救培训
DOI：
10.1155/2019/5048794
复制
发表时间：
2019
影响因子：
2.8
通讯作者：
A. Marson
中科院分区：
文献类型：
--
作者：
A. Noble;Darlene A Snape;L. Ridsdale;M. Morgan;S. Nevitt;S. Goodacre;A. Marson
目的：在英国进行的一项随机对照试验中，对前往急诊科（艾德）和非正式护理人员的癫痫成年患者进行集体癫痫发作急救培训干预，以测量其保真度。其影响的估计，包括对艾德的使用，将由试验产生。虽然几乎从未报道过癫痫干预试验只有一个关于这个主题的出版物存在，这项研究提供了必要的治疗保真度的信息，使试验的估计得到准确的解释。这一罕见的关于如何评估忠诚度的工作实例也可以为神经病学trialists提供如何评估忠诚度的指导。方法选取53例在前一年内就诊≥2次的艾德患者，随机分为干预组26例。一名主持人为他们举办了7次干预课程。使用录音，治疗的“依从性”和“能力”进行了评估。依从性评估的项目组成的干预清单。使用计算机软件，能力进行了测量，通过计算辅导员的讲话在干预（说教）。评分员间的可靠性进行了评估，由两个独立的评分员评估每门课程使用的措施和他们的评级进行比较。结果保真度测量结果可靠。对于依从性工具，评分者同意96%的时间，PABAK-OS kappa 0.91。对于说教，评分员的分数有一个组内系数为0.96。在治疗保真度方面，不仅发现课程具有良好的依从性（88%的项目完全交付），而且按照预期，它们具有高度的互动性，主持人平均占课程时间的55%。结论忠诚度的措施是可靠的，并表明干预是交付出席。因此，任何干预效果的估计不会受到实施保真度差的影响。
Purpose To measure fidelity with which a group seizure first aid training intervention was delivered within a pilot randomized controlled trial underway in the UK for adults with epilepsy who visit emergency departments (ED) and informal carers. Estimates of its effects, including on ED use, will be produced by the trial. Whilst hardly ever reported for trials of epilepsy interventions—only one publication on this topic exists—this study provides the information on treatment fidelity necessary to allow the trial's estimates to be accurately interpreted. This rare worked example of how fidelity can be assessed could also provide guidance sought by neurology trialists on how to assess fidelity. Methods 53 patients who had visited ED on ≥2 occasions in prior year were recruited for the trial; 26 were randomized to the intervention. 7 intervention courses were delivered for them by one facilitator. Using audio recordings, treatment “adherence” and “competence” were assessed. Adherence was assessed by a checklist of the items comprising the intervention. Using computer software, competence was measured by calculating facilitator speech during the intervention (didacticism). Interrater reliability was evaluated by two independent raters assessing each course using the measures and their ratings being compared. Results The fidelity measures were found to be reliable. For the adherence instrument, raters agreed 96% of the time, PABAK-OS kappa 0.91. For didacticism, raters' scores had an intraclass coefficient of 0.96. In terms of treatment fidelity, not only were courses found to have been delivered with excellent adherence (88% of its items were fully delivered) but also as intended they were highly interactive, with the facilitator speaking for, on average, 55% of course time. Conclusions The fidelity measures used were reliable and showed that the intervention was delivered as attended. Therefore, any estimates of intervention effect will not be influenced by poor implementation fidelity.
影响因子：
4.2
作者：
Bellg, AJ;Borrelli, B;Czajkowski, S
通讯作者：
Czajkowski, S