The application of interrupted time series designs for the evaluation of public health interventions

间断时间序列设计在公共卫生干预评估中的应用

• 批准号: MR/L011891/1
• 负责人: James Lopez Bernal
• 金额: $ 29.36万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2014
• 资助国家: 英国
• 起止时间: 2014 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FL011891%2F1
• 关键词: application; interrupted; time; series; designs

What is the context of the research?Public health interventions (such as smoking legislation, health promotion programmes and health service changes) are generally applied to whole populations rather than individuals. Often, this means that traditional methods for evaluating whether an intervention works, such as a clinical trial for a new drug, cannot be applied. This results in a lack of knowledge about which public health interventions are most effective at improving health, resulting in inappropriate resource allocation with good interventions not being implemented and poor interventions being continued. One powerful method to evaluate interventions, which is frequently used in other fields such as economics, policy research and education research, but less commonly in health research, is interrupted time series (ITS) analysis. The basic principle is to compare the outcome of interest over time before and after an intervention whilst taking into account any underlying trends. Further development of this method in the context of public health will enable more robust evaluation of complex public health interventions.To which disease(s)/ condition(s), if any, is the research relevant?This research is relevant to the evaluation of all population level health interventions as well as some individual level health interventions which are not amenable to clinical trials.What is the research trying to achieve?This project aims to export and develop the ITS technique as a robust method to evaluate the effectiveness of public health interventions, implement the method in the evaluation of real life public health interventions and develop comprehensive guidelines on the appropriate usage of ITS methods in this field.Why is this important?This research will help us to accurately evaluate population level health interventions that would otherwise be difficult to evaluate. This is important for ensuring that the highest quality interventions which lead to the greatest health gains are implemented in practice.Who is carrying out the research?Dr James Lopez Bernal (Academic Clinical Fellow in Public Health) will be conducting this research for his PhD at the London School of Hygiene and Tropical Medicine. He will be supervised by Professor Steven Cummins (Professor of Population Health) who is an expert in the evaluation of public health interventions, and Dr Antionio Gasparrini (Lecturer in Biostatistics and Epidemiology) whose main research focus lies in time series analysis. The research will also involve collaboration with the Department of Population Medicine at Harvard University.How is the research being conducted?1) Existing knowledge on ITS methods from other disciplines will be collated and reviewed in order to understand where methods may be directly applicable to public health interventions and where there may be differences. Published ITS studies of public health interventions will then be reviewed in order to evaluate specific designs and analytical methods used and any methodological issues arising from them.2) At least two case studies will be conducted in which an ITS design will be used to evaluate the effectiveness of real life public health interventions, including:- Evaluation of the effect of a workplace health and wellbeing programme on ill health among employees.- Evaluation of the effect of the move to GP led commissioning of services in the NHS on referrals to specialist hospital care.3) Issues identified during the earlier stages of the project will be addressed by developing techniques to improve the robustness and accuracy of the ITS method and testing these on the case studies.4) The knowledge and experience gained during this research will be used to develop guidelines on the appropriate use of ITS designs for the evaluation of public health interventions.

研究的背景是什么？公共卫生干预措施（如吸烟立法、健康促进方案和卫生服务改革）一般适用于全体人口，而不是个人。通常，这意味着评估干预措施是否有效的传统方法，如新药的临床试验，无法应用。这导致对哪些公共卫生干预措施最有效地改善健康缺乏了解，导致资源分配不当，良好的干预措施没有得到实施，糟糕的干预措施仍在继续。一种评估干预措施的有力方法是中断时间序列（ITS）分析，这种方法经常用于经济学、政策研究和教育研究等其他领域，但在卫生研究中不太常用。基本原则是在考虑到任何潜在趋势的同时，在干预前后一段时间内比较兴趣的结果。在公共卫生领域进一步发展这一方法，将有助于对复杂的公共卫生干预措施进行更有力的评估。如果有的话，该研究与哪些疾病/状况有关？本研究涉及所有人群水平的健康干预措施的评估，以及一些不适合临床试验的个人水平的健康干预措施。这项研究想要达到什么目的？本项目旨在出口和发展ITS技术，作为评估公共卫生干预措施有效性的一种强有力的方法，在评估现实生活中的公共卫生干预措施中实施该方法，并制定关于在该领域适当使用ITS方法的综合准则。为什么这很重要？这项研究将帮助我们准确评估人口水平的健康干预措施，否则将难以评估。这对于确保在实践中实施导致最大健康收益的最高质量干预措施非常重要。谁在进行这项研究？James Lopez Bernal博士（公共卫生学术临床研究员）将在伦敦卫生和热带医学学院进行这项博士研究。他将由Steven Cummins教授（人口健康教授）和antonio Gasparrini博士（生物统计学和流行病学讲师）指导，前者是公共卫生干预措施评估方面的专家，后者的主要研究重点是时间序列分析。这项研究还将涉及与哈佛大学人口医学系的合作。这项研究是如何进行的？1)将整理和审查来自其他学科的关于ITS方法的现有知识，以便了解哪些方法可以直接适用于公共卫生干预措施，以及哪些方法可能存在差异。然后将审查已发表的卫生服务处公共卫生干预研究，以评价所使用的具体设计和分析方法以及由此产生的任何方法学问题。2)将进行至少两个案例研究，其中将使用ITS设计来评估现实生活中的公共卫生干预措施的有效性，包括：-评估工作场所健康和福利方案对员工健康不良的影响。-评估由全科医生主导的国民保健服务转介到专科医院护理的效果。3)在项目早期阶段发现的问题将通过开发技术来解决，以提高ITS方法的稳健性和准确性，并在案例研究中进行测试。4)在这项研究中获得的知识和经验将用于制定关于适当使用ITS设计来评估公共卫生干预措施的指导方针。

项目成果

Mastering Public Health

掌握公共卫生

• DOI: 10.1201/b17699
• 发表时间: 2014
• 作者: Lewis G

The use of controls in interrupted time series studies of public health interventions

• DOI: 10.1093/ije/dyy135
• 发表时间: 2018-12-01
• 期刊: INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
• 影响因子: 7.7
• 作者: Bernal, James Lopez;Cummins, Steven;Gasparrini, Antonio
• 通讯作者: Gasparrini, Antonio

The Impact of Social and Physical Distancing Measures on COVID-19 Activity in England

社交和身体距离措施对英格兰 COVID-19 活动的影响

• DOI: 10.2139/ssrn.3608109
• 发表时间: 2020
• 期刊: SSRN Electronic Journal
• 作者: Bernal J

Interrupted time series regression for the evaluation of public health interventions: a tutorial.

• DOI: 10.1093/ije/dyw098
• 发表时间: 2017-02-01
• 期刊: International journal of epidemiology
• 影响因子: 7.7
• 作者: Bernal JL;Cummins S;Gasparrini A
• 通讯作者: Gasparrini A

The use of interrupted time series for the evaluation of public health interventions

• DOI: 10.17037/pubs.04648680
• 发表时间: 2018-07
• 作者: James Andrés López;A. Gasparrini;S. Cummins;Stephen B. Soumerai;Martin J. McKee