Can pragmatic trials help us better understand chronic pain and improve treatment?

被引：39

作者：

Rowbotham, Michael C. ^{[1
]}

Gilron, Ian ^{[2
,3
]}

Glazer, Clara ^{[1
,4
]}

Rice, Andrew S. C. ^{[5
]}

Smith, Blair H. ^{[6
]}

Stewart, Walter F. ^{[7
]}

Wasan, Ajay D. ^{[8
,9
,10
]}

机构：

[1] Calif Pacific Med Ctr, Res Inst, San Francisco, CA 94107 USA

[2] Queens Univ, Dept Anesthesiol & Perioperat Med, Kingston, ON, Canada

[3] Queens Univ, Dept Biomed & Mol Sci, Kingston, ON, Canada

[4] Univ Copenhagen, Rigshosp, Dept Anesthesia, DK-2100 Copenhagen, Denmark

[5] Chelsea & Westminster Hosp NHS Fdn Trust, Imperial Coll London & Pain Med, Fac Med, Dept Surg & Canc, London, England

[6] Univ Dundee, Ninewells Hosp & Med Sch, Div Populat Hlth Sci, Dundee DD1 9SY, Scotland

[7] Sutter Hlth Res & Dev, Concord, CA USA

[8] Brigham & Womens Hosp, Dept Anesthesiol, Boston, MA 02115 USA

[9] Brigham & Womens Hosp, Dept Psychiat, Boston, MA 02115 USA

[10] Harvard Univ, Sch Med, Boston, MA USA

来源：

PAIN | 2013年 / 154卷 / 05期

关键词：

CLINICAL-TRIAL; PRIMARY-CARE; DESIGN; ANTAGONISTS; ADHERENCE; 1ST-LINE; OPIOIDS;

D O I：

10.1016/j.pain.2013.02.034

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Pragmatic trials assessing effectiveness complement efficacy trials for improving clinical care. Efficacy trials of novel interventions, especially for regulatory purposes, may not translate to obvious effectiveness once the interventions enter routine clinical practice. This translation gap may exist for a number of reasons, relating to ''real world'' populations and health care systems, or the presence of unidentified confounders and comorbidities. While pragmatic trials have limitations, approaches such as those suggested here should be considered by the clinical and academic pain community.

引用

页码：643 / 646

页数：4

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