比较效益研究的设计、实施和分析方法概述

Overview of design,implementation and analysis of comparative effectiveness research

比较效益研究(comparative effectiveness research,CER)被认为是一种可以提升医疗卫生研究质量的有力工具,该工具从策略层面上有益降低医疗卫生成本。比较效益研究的提出仍然源自于"效力"和"效果"的研究问题。以往的效力研究总是在较为严格的控制条件下探索干预措施是否有效,而现今的医学研究除了探索有效之外,更关注针对谁有效,在哪一种情况下有效的效果问题。过去经典的效力研究常通过比较一种新干预措施和安慰剂,来获得其效力的评价。现今CER发展到对两种或多种不同干预措施进行直接对比,而且强调在尽可能接近临床实际减少人为控制因素的情况下进行对比。该文通过对系列文献和报告的归纳和总结,就如何设计、实施、分析CER,进行了分析和综述,为以后中医药研究者开展类似研究提供参考。

Comparative effectiveness research （CER） has been regarded as a hot topic in health care recently. Many medicalr esearchers currently deem CER as a potential powerful instrument for improving the quality of heahhcare and cut medical cost. Howev er, in the past, classic efficacy studies are always focusing on comparing one new intervention with placebo under complete controlled environment. Now CER turns to comparing different interventions directly in real world of routine practice. This article reviewed a se ries of literature about the design, implementation and analysis of CER in order to give a clue for Chinese medicine researchers in fu ture.