确定目标人群,以满足决策者的需求。

IF 5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American journal of epidemiology Pub Date : 2024-11-04 DOI:10.1093/aje/kwae129
Jennifer L Lund, Anthony A Matthews
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引用次数: 0

摘要

随机试验估计的是符合条件、受邀并同意参加试验的个人的平均治疗效果。然而,决策者往往需要超出试验入组人群范围的证据,以便为其特定目标人群的政策或行动提供依据。每个决策者都有不同的目标人群,这些人群的构成可能与试验人群的构成并不一致。作为研究人员,我们应该在研究过程的早期就确定我们要为其提供证据的决策者。然后,我们就可以指定他们感兴趣的目标人群,并确定是否可以仅利用试验结果为政策或行动提供信息,或者是否需要额外的补充性真实世界数据和分析。在本评论中,我们概述了决策者的五个主要群体:决策者、支付者、购买者、提供者和患者。然后,我们为对射血分数保留的心肌梗死后β-受体阻滞剂的有效性感兴趣的决策者明确了相关目标人群。最后,我们总结了随机试验结果可能适用于或不适用于这些目标人群的情况,并提出了相关的分析方法,这些方法可以产生更符合决策者需求的证据。
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Identifying target populations to align with decision-makers' needs.

Randomized trials estimate the average treatment effect within individuals who are eligible, invited, and agree to enroll. However, decision-makers often require evidence that extends beyond the trial's enrolled population to inform policy or actions for their specific target population. Each decision-maker has distinct target populations, the composition of which may not often align with that of the trial population. As researchers, we should identify a decision-maker for whom we aim to generate evidence early in the research process. We can then specify a target population of their interest and determine if a policy or action can be informed using results from a trial alone, or if additional complementary real-world data and analysis are required. In this commentary, we outline 5 key groupings of decision-makers: policymakers, payers, purchasers, providers, and patients. We then specify relevant target populations for decision-makers interested in the effectiveness of beta-blockers after a myocardial infarction with preserved ejection fraction. Finally, we summarize the scenarios in which results from a randomized trial may or may not apply to these target populations and suggest relevant analytic approaches that can generate evidence to better align with a decision-maker's needs. This article is part of a Special Collection on Pharmacoepidemiology.

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来源期刊
American journal of epidemiology
American journal of epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.40
自引率
4.00%
发文量
221
审稿时长
3-6 weeks
期刊介绍: The American Journal of Epidemiology is the oldest and one of the premier epidemiologic journals devoted to the publication of empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research. It is a peer-reviewed journal aimed at both fellow epidemiologists and those who use epidemiologic data, including public health workers and clinicians.
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