To RCT or not to RCT: deciding when 'more evidence is needed' for public health policy and practice
To RCT or not to RCT: deciding when 'more evidence is needed' for public health policy and practice
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DOI：
10.1136/jech.2010.116483
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发表时间：
2012-05-01
影响因子：
6.3
通讯作者：
Jones, David R.
中科院分区：
文献类型：
--
作者：
Petticrew, Mark;Chalabi, Zaid;Jones, David R.
在对“更多公共卫生证据”的呼吁中，我们还需要简单易懂的方法来确定何时真正需要更多的研究。本文介绍了一个简单的决策辅助工具，以帮助决策者、研究人员和其他决策者评估一项新的公共卫生随机对照试验的潜在“信息价值”。方法作者开发了一个流程图，以帮助明确（1）用户的信息需求，（2）研究将产生的新信息的预期用途，（3）从新研究中获得的证据的附加值和（4）用户所需的精确度、偏倚和普遍性水平。结果流程图简要说明，首先是一般形式，然后是工作示例，展示了如何使用它来决定是否应该委托一项新的研究来评估允许摩托车使用伦敦公共汽车道对健康的影响。结论在本文中，作者提出了一个流程图，用于制定一个非正式的“信息价值”样的方法，以决定何时需要新的公共卫生评估。作者并不认为流程图方法在技术上等同于信息价值方法。尽管如此，它代表了一个有价值的观点和过程，这种结构化的方法将比非结构化的思想实验更能揭示新研究的决策基础。为了帮助其发展成为一个有效的工具，我们邀请来自不同角度和背景的用户对其进行审查，在实践中使用它，并向我们发送他们的意见。
Background Amid the calls for 'more public health evidence', we also need simple understandable methods of determining when more research really is needed. This paper describes a simple decision aid to help policymakers, researchers and other decision makers assess the potential 'information value' of a new public health randomised controlled trial.Methods The authors developed a flow chart to help make explicit (1) the user's information needs, (2) the intended use of the new information that the study will produce, (3) the added value of the evidence to be derived from the new study and (4) the levels of precision, bias and generalisability required by the user.Results The flow chart is briefly illustrated, first in generic form and then in a worked example, showing how it may be used in deciding whether a new study should be commissioned to evaluate the health impact of allowing motorcycles to use bus lanes in London.Conclusions In this paper, the authors have presented a flow chart for enacting an informal 'Value-of-Information'- like approach to deciding when a new public health evaluation is needed. The authors do not suggest that the flow chart approach is technically the equivalent of Value-of-Information methods. Nonetheless, it represents a valuable perspective and process to adopt, and this structured approach will be more revealing than an unstructured thought experiment as the basis for decisions about a new study. To aid in its development as an effective tool, we invite users from a variety of perspectives and contexts to review it, to use it in practice and to send us their comments.