Randomisation and resource allocation: a missed opportunity for evaluating health care and social interventions
Randomisation and resource allocation: a missed opportunity for evaluating health care and social interventions
复制标题
随机化和资源分配：错过了评估医疗保健和社会干预措施的机会
DOI：
10.1136/jme.26.5.319
复制
发表时间：
2000
影响因子：
4.1
通讯作者：
A. Oakley
中科院分区：
文献类型：
--
作者：
Tami Toroyan;I. Roberts;A. Oakley
平衡被广泛认为是随机对照试验伦理行为的必要先决条件。然而，在某些情况下，在缺乏平衡的情况下进行随机对照试验（RCT）是可以接受的。有限地获得首选干预措施就是这种情况之一。在本文中，我们提出了一个随机试验的例子，其中获得首选的干预措施，学前教育，是严重限制了资源的限制。在进行医疗保健随机试验时出现的伦理问题被认为是在社会干预试验的背景下。在保健、教育和社会福利方面，由于预算限制，有效的干预措施往往受到限制。明确承认定量干预的必要性，并在缺乏均衡的情况下使用随机分配来做到这一点，将有助于更多地了解这些干预措施的效果。
Equipoise is widely regarded to be an essential prerequisite for the ethical conduct of a randomised controlled trial. There are some circumstances however, under which it is acceptable to conduct a randomised controlled trial (RCT) in the absence of equipoise. Limited access to the preferred intervention is one such circumstance. In this paper we present an example of a randomised trial in which access to the preferred intervention, preschool education, was severely limited by resource constraints. The ethical issues that arise when conducting randomised trials in health care are considered in the context of trials of social interventions. In health, education and social welfare, effective interventions are frequently limited due to budgetary constraints. Explicit acknowledgement of the need to ration interventions, and the use of random allocation to do this even in the absence of equipoise, would facilitate learning more about the effects of these interventions.