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首页> 外文期刊>Palliative medicine >The randomized fast-track trial in palliative care: role, utility and ethics in the evaluation of interventions in palliative care?
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The randomized fast-track trial in palliative care: role, utility and ethics in the evaluation of interventions in palliative care?

机译：姑息治疗随机快速跟踪试验：姑息治疗干预措施评估中的作用，效用和伦理学？

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BACKGROUND: Randomized trials are the gold standard method for evaluating treatments and services in health care. However, they are often difficult to complete in palliative care, and suffer from poor recruitment. AIM: To introduce the randomized fast-track trial and its potential use in palliative care. METHOD: The randomized fast-track trial is a form of randomized trial with two periods. In the first, the trial runs as a normal randomized trial. In the second period, the standard (control) group also are offered the intervention. The design is adapted from a 'wait list' design (sometimes called a deferred entry or delayed intervention trial) but is both less confusing for patients, who are not on waiting lists, and more appropriate to the nature of services offered. The methodology has the advantage of being more acceptable to many patients, clinicians and ethics committees than standard randomized trials, because all patients will eventually be offered the intervention. Yet it has the rigour of a traditional randomized trial. However, care is needed to ensure the correct timing for the first period, before the standard group receive the intervention. The analysis of data in the second period is complex. CONCLUSION: The fast-track trial has been used successfully in palliative care among patients severely affected by multiple sclerosis, chronic obstructive pulmonary disease and cancer. It is best suited to evaluations of palliative care services among patients who have longer prognoses, for example of several months or more although it has been used in people with prognoses of weeks.
机译：背景：随机试验是评估卫生保健中治疗和服务的金标准方法。但是，他们通常在姑息治疗中难以完成，而且招募工作差。目的：介绍随机快速跟踪试验及其在姑息治疗中的潜在用途。方法：随机快速通道试验是具有两个时期的随机试验的一种形式。首先，该试验作为正常的随机试验进行。在第二阶段，标准（对照组）小组也被提供干预。该设计改编自“等待名单”设计（有时称为延期入境或延迟干预试验），但对于不在等待名单上的患者而言，混乱性较小，而且更适合所提供服务的性质。与标准随机试验相比，该方法具有许多患者，临床医生和伦理委员会更易于接受的优点，因为最终将为所有患者提供干预措施。然而，它具有传统随机试验的严格性。但是，在标准组接受干预之前，需要注意确保第一时间的正确时机。第二阶段的数据分析很复杂。结论：该快速试验已成功用于多发性硬化症，慢性阻塞性肺疾病和癌症严重患者的姑息治疗。它最适合于对预后较长的患者（例如，数月或更长时间）的姑息治疗服务进行评估，尽管它已被用于预后数周的患者。

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