首页|The Potential for Pragmatic Trials to Reduce Racial and Ethnic Disparities in Kidney Disease
The Potential for Pragmatic Trials to Reduce Racial and Ethnic Disparities in Kidney Disease
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NSTL
Amer Soc Nephrology
The well-documented and unacceptable racial and ethnic disparities in the prevalence and outcomes of kidney disease are receiving increased attention within and beyond the nephrology community, with numerous calls for intentional, active approaches to ensure that care is equitable and that disparities are eliminated. In 2003, the Institute of Medicine (now the National Academy of Medicine) concluded that elimination of racial disparities in health outcomes requires a multilevel approach directed at health systems, patients, care providers, and payors. While some strategies should be adopted because they are clearly the right thing to do, others require rigorous evaluation before broad uptake to understand the benefits, unanticipated harms, relative value, and challenges to implementation. Pragmatic or “real-world” clinical trials have received substantial interest during the past decade because they yield results that are highly generalizable to the nontrial setting, evaluate interventions that can be readily transferred to clinical practice, and save money by leveraging clinical care systems rather than relying on separate research infrastructure. Pragmatic trials are most often used for comparative effectiveness research to identify advantages and disadvantages of treatment approaches already in widespread clinical use, or to evaluate strategies for implementing or increasing uptake of interventions known to have efficacy.
Laura M. Dember
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Renal, Electrolyte, and Hypertension Division, Department of Medicine
NSTL
Amer Soc Nephrology
