首页|基于适应性干预与顺序多重分配随机试验设计探讨中医"辨证论治"治疗策略的评价方法

基于适应性干预与顺序多重分配随机试验设计探讨中医"辨证论治"治疗策略的评价方法

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现代临床研究评价体系越来越重视"个体"患者的临床特征、诊疗方案、复杂干预措施的评价.传统随机对照试验多适用于评价固定干预、非适应性治疗方案,无法满足评价适应性干预的需求,使得研究者更加倾向探索一种个体化、适应性的临床试验设计,顺序多重分配随机试验(sequential multiple assignment randomized trial,SMART)应势而生.本文介绍SMART设计的原理、关键要素和实施要点,进一步探析传统临床试验设计与中医辨证论治不相适应的局限性,并通过实例展示SMART设计能够较好地满足中医临床试验的需求,有着广阔的发展前景,期望为研究者在设计临床试验方案时提供有益的借鉴和启发.
Evaluation method of"syndrome differentiation"of TCM based on adaptive interventions and sequential multiple assignment randomized trial
The modern clinical research evaluation systems have increasingly emphasized the evaluation of individual patients'clinical characteristics,diagnosis and treatment plans,and complex intervention measures.Traditional randomized controlled trials evaluate fixed interventions and non-adaptive treatment plans,which cannot meet the needs of evaluating adaptive interventions.This has made researchers more inclined to explore an individualized and adaptive clinical trial design,and sequential multiple assignment randomized trial(SMART)has emerged as needed.This article introduces the principles,key elements,and implementation points of SMART design,further explores the limitations of the mismatch between traditional Chinese medicine clinical trial design and syndrome differentiation treatment,and proposes that SMART design can meet the needs of traditional Chinese medicine clinical trials to inspire researchers in designing their plans.

Sequential multiple assignment randomized trial(SMART)Adaptive interventionClinical trial designAdaptive designInterim analysis

周莎、帅雨杏、吉萌萌、钱真真、姜燕华、荆志伟、刘炽、李红毅、禤国维、陈新林

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广州中医药大学第二临床医学院(广州 510403)

广州中医药大学基础医学院(广州 510006)

宁夏大学生命科学学院(银川 750021)

中国中医科学院中医临床基础医学研究所(北京 100700)

广东省中医院皮肤科(广州 510120)

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顺序多重分配随机试验 适应性干预 临床试验设计 适应性设计 期中分析

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(12)