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癌症青少年的研究重点:英国与詹姆斯·林德联盟的优先事项设定合作项目

Research priorities for young people with cancer: a UK priority setting partnership with the James Lind Alliance.

作者信息

Aldiss Susie, Fern Lorna A, Phillips Robert S, Callaghan Amy, Dyker Karen, Gravestock Helen, Groszmann Michael, Hamrang Leila, Hough Rachael, McGeachy Demi, Morgan Sue, Smith Sam, Upadhyaya Sheela, Veitch Helen, Veitch Lara, Williamson Max, Whelan Jeremy S, Gibson Faith

机构信息

School of Health Sciences, University of Surrey, Guildford, UK.

Oncology Division, University College London Hospitals NHS Foundation Trust, London, UK.

出版信息

BMJ Open. 2019 Aug 5;9(8):e028119. doi: 10.1136/bmjopen-2018-028119.

Abstract

OBJECTIVES

To conduct a UK-wide survey of young people who have experienced cancer, carers and professionals, to identify and prioritise research questions to inform decisions of research funders and support the case for research with this unique cancer population.

DESIGN

James Lind Alliance Priority Setting Partnership.

SETTING

UK health service and community.

METHODS

A steering group oversaw the initiative and partner organisations were recruited. Unanswered questions were collected in an online survey. Evidence searching verified uncertainties. An interim survey was used to rank questions prior to a final prioritisation workshop.

PARTICIPANTS

Young people aged 13-24 years with a current or previous cancer diagnosis, their families, friends, partners and professionals who work with this population.

RESULTS

Two hundred and ninety-two respondents submitted 855 potential questions. Following a refining process and removal of 'out of scope' questions, 208 unique questions remained. Systematic evidence checking identified seven answered questions and 16 were the subject of ongoing studies. The interim survey was completed by 174 participants. The top 30 questions were prioritised at a workshop attended by 25 young people, parents and multidisciplinary professionals. The top three priorities are: (1) What psychological support package improves psychological well-being, social functioning and mental health during and after treatment? (2) What interventions, including self-care, can reduce or reverse adverse short-term and long-term effects of cancer treatment? (3) What are the best strategies to improve access to clinical trials? The remaining questions reflect the complete cancer pathway: new therapies, life after cancer, support, education/employment, relapse and end-of-life care.

CONCLUSIONS

We have identified shared research priorities for young people with cancer using a rigorous, person-centred approach involving stakeholders typically not involved in setting the research agenda. The breadth of priorities suggest future research should focus on holistic and psychosocial care delivery as well as traditional drug/biology research.

摘要

目标

在全英国范围内对曾患癌症的年轻人、护理人员和专业人士开展一项调查,以确定研究问题并排出优先顺序,为研究资助者的决策提供依据,并支持针对这一独特癌症群体开展研究的理由。

设计

詹姆斯·林德联盟优先事项设定合作项目。

背景

英国医疗服务机构及社区。

方法

由一个指导小组监督该倡议,并招募合作组织。通过在线调查收集未解答的问题。证据检索核实不确定性。在最终的优先事项确定研讨会之前,通过一项中期调查对问题进行排序。

参与者

年龄在13至24岁之间、目前或曾被诊断患有癌症的年轻人,他们的家人、朋友、伴侣以及与该群体打交道的专业人士。

结果

292名受访者提交了855个潜在问题。经过提炼过程并剔除“超出范围”的问题后,剩下208个独特问题。系统的证据核查确定了7个已解答的问题,16个是正在进行的研究课题。174名参与者完成了中期调查。在由25名年轻人、家长和多学科专业人士参加的研讨会上,确定了前30个优先问题。前三大优先事项是:(1)何种心理支持方案能改善治疗期间及治疗后的心理健康、社会功能和精神状态?(2)包括自我护理在内的哪些干预措施可减少或逆转癌症治疗的短期和长期不良影响?(3)改善临床试验准入的最佳策略是什么?其余问题反映了完整的癌症历程:新疗法、癌症后的生活、支持、教育/就业、复发和临终关怀。

结论

我们采用了一种严谨的、以患者为中心的方法,让通常不参与设定研究议程的利益相关者参与进来,确定了针对患癌年轻人的共同研究优先事项。优先事项的广泛程度表明,未来的研究应侧重于整体和心理社会护理,以及传统的药物/生物学研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/028a/6688702/ba0173380116/bmjopen-2018-028119f01.jpg

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