Applying the Multiphase Optimization Strategy for the Development of Optimized Interventions in Palliative Care.
Applying the Multiphase Optimization Strategy for the Development of Optimized Interventions in Palliative Care.
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DOI：
10.1016/j.jpainsymman.2020.11.017
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发表时间：
2021-07
影响因子：
4.7
通讯作者：
Dionne-Odom JN
中科院分区：
文献类型：
--
作者：
Wells RD;Guastaferro K;Azuero A;Rini C;Hendricks BA;Dosse C;Taylor R;Williams GR;Engler S;Smith C;Sudore R;Rosenberg AR;Bakitas MA;Dionne-Odom JN
最近的系统评价和荟萃分析报告了多成分“捆绑”姑息治疗干预措施对患者和家庭护理人员的积极益处，同时强调了确定关键要素和改进机制的局限性。传统的研究方法，例如随机对照试验（RCT），通常将干预措施视为“捆绑”的治疗方案，因此很难明确评估干预措施的哪些方面可以减少或替代，或者干预措施之间是否存在协同或拮抗相互作用。走向有效、高效和可扩展的姑息治疗干预措施需要新的策略和新的方法。其中一种方法是多阶段优化策略（MOST），这是一个以工程原理为基础的框架，它使用系统过程来凭经验确定由在现实生活约束下对预期结果做出积极贡献的组件组成的干预措施。本文简要概述了 MOST 和析因试验设计在姑息治疗研究中的应用，包括我们对早期姑息治疗干预措施进行试点析因试验以增强晚期癌症家庭护理人员的决策支持技能（CASCADE 项目）的见解。
Recent systematic reviews and meta-analyses have reported positive benefit of multicomponent “bundled” palliative care interventions for patients and family caregivers while highlighting limitations in determining key elements and mechanisms of improvement. Traditional research approaches, such as the randomized controlled trial (RCT), typically treat interventions as “bundled” treatment packages, making it difficult to assess definitively which aspects of an intervention can be reduced or replaced or whether there are synergistic or antagonistic interactions between intervention components. Progressing toward palliative care interventions that are effective, efficient, and scalable will require new strategies and novel approaches. One such approach is the Multiphase Optimization Strategy (MOST), a framework informed by engineering principles, that uses a systematic process to empirically identify an intervention comprised of components that positively contribute to desired outcomes under real-life constraints. This article provides a brief overview and application of MOST and factorial trial design in palliative care research, including our insights from conducting a pilot factorial trial of an early palliative care intervention to enhance the decision support skills of advanced cancer family caregivers (Project CASCADE).
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影响因子：
7
作者：
Collins, Linda M.;Dziak, John J.;Li, Runze
通讯作者：
Li, Runze
影响因子：
2.8
作者：
Aslakson, Rebecca A.;Reinke, Lynn F.;Curtis, J. Randall
通讯作者：
Curtis, J. Randall
影响因子：
5.5
作者：
Collins, Linda M.;Dziak, John J.;Kugler, Kari C.;Trail, Jessica B.
通讯作者：
Trail, Jessica B.
影响因子：
3.3
作者：
Celano, Christopher M.;Albanese, Ariana M.;Huffman, Jeff C.
通讯作者：
Huffman, Jeff C.
DOI：
10.1001/jama.2016.16840
发表时间：
2016-11-22
期刊：
JAMA
影响因子：
--
作者：
Kavalieratos D;Corbelli J;Zhang D;Dionne-Odom JN;Ernecoff NC;Hanmer J;Hoydich ZP;Ikejiani DZ;Klein-Fedyshin M;Zimmermann C;Morton SC;Arnold RM;Heller L;Schenker Y
通讯作者：
Schenker Y