Abstract:BackgroundDespite their close relationship, clinical research and medical care have become separated by clear boundaries. The purpose of clinical research is to generate generalizable knowledge useful for future patients, whereas medical care aims to promote the well-being of individual patients. The evolution towards patient-centered medicine and patient-oriented research, and the gradual standardization of medicine are contributing to closer ties between clinical research and medical practice. But the integr… Show more
“…Health professionals’ perception of progressive divergence between clinical research and standard health care has been reported to have serious repercussions on the professional practice of CRNs (Bowers, ). Sacristán () found that despite their close relationship, clinical research and medical care have become separated by clear boundaries and their integration required researchers, clinicians, healthcare managers and patients to re‐evaluate the way they understand research, in relation to the potential benefits for present and future patients. CRNs membership in clinical research enterprise was reported as an ongoing struggle to establish the significance and validity of their service within standard care settings:Once you establish that we (CRN and non‐research colleague) are not enemies here and some of the studies that we have got a drug which is very advantageous to this kind of disease…and you work together, it's good.…”
“…Health professionals’ perception of progressive divergence between clinical research and standard health care has been reported to have serious repercussions on the professional practice of CRNs (Bowers, ). Sacristán () found that despite their close relationship, clinical research and medical care have become separated by clear boundaries and their integration required researchers, clinicians, healthcare managers and patients to re‐evaluate the way they understand research, in relation to the potential benefits for present and future patients. CRNs membership in clinical research enterprise was reported as an ongoing struggle to establish the significance and validity of their service within standard care settings:Once you establish that we (CRN and non‐research colleague) are not enemies here and some of the studies that we have got a drug which is very advantageous to this kind of disease…and you work together, it's good.…”
“…For PCM, it is necessary to treat individual patients according to their heterogeneous characteristics [18]. The development of PCM requires patient-oriented research, focused on the individualization of results, disaggregation of data, and analysis of differences in subgroups [19]. Patients generally have many attributes, thus, previous studies using conventional subgroup analyses are limited, as classifications were based on a single variable (e.g., male vs. female, elderly vs. young) [16].…”
Background/Aims: Cross-classification analyses are rarely reported. We investigated the prognostic factors for chronic kidney disease (CKD) progression using a body mass index (BMI)-based cross-classification approach. Methods: Patients’ renal outcome (≥50% decline in the estimated glomerular filtration rate or end-stage renal disease) in each subcohort was examined. Results: The number of prognostic factors identified in the multivariate Cox analysis was smaller in the “BMI ≥25, female” and CKD stage 3 subcohorts than in other subcohorts. Prognostic factors identified in the “BMI ≥25, CKD stage 3” subcohort only comprised albuminuria and male sex, and those in the “BMI ≥25, female” subcohort only comprised albuminuria, hyperphosphatemia, and anemia. Albuminuria, kidney impairment, male sex, hyperphosphatemia, anemia, and increased pulse pressure × heart rate product (PP × HR; pulsatile stress) were stable renal prognostic factors in almost all subcohorts. On the other hand, the prognostic value of increased BMI, younger age, hypoalbuminemia, increased intact parathyroid hormone, and decreased estimated 24-h urinary potassium excretion (e24hUK) differed according to subcohort. BMI was positively associated with CKD progression in the “BMI ≥25, age ≥65 years” and “BMI ≥25, CKD stages 4–5” subcohorts, whereas it was negatively associated with CKD progression in the “BMI <25, diabetes mellitus” subcohort. PP × HR was independently associated with CKD progression in the “BMI <25, CKD stage 3” subcohort, which had relatively few identified renal prognostic factors. Decreased e24hUK was a renal prognostic factor for CKD progression in the “BMI <25, CKD stages 4–5” subcohort, while no significant factors were observed in the “BMI ≥25, CKD stages 4–5” subcohort. Conclusion: A BMI-based cross-classification approach, which provides more comprehensive findings than that in previous approaches, is expected to be an effective method for evaluating renal prognostic factors in patients with CKD who are affected by multiple risk factors.
“…Publications on strategies to improve recruitment rates, to retain participants in clinical research, and to facilitate researcher‐clinician collaboration reported difficulties in combining clinical and research roles, where the main reasons were the lack of time, ethical concerns, and absence of leadership, particularly in the field of nursing . The discussed models of combining clinical and research activities in various health fields were collaboration, partnership, and integration . However, the process of routinisation of RCTs in clinical practice has not been discussed as a holistic process and as a separate model, including in the field of wound management.…”
Section: Introductionmentioning
confidence: 99%
“…33 The discussed models of combining clinical and research activities in various health fields were collaboration, partnership, and integration. [34][35][36][37] However, the process of routinisation of RCTs in clinical practice has not been discussed as a holistic process and as a separate model, including in the field of wound management. In this article, we have developed the Routinisation of Trials Framework, analysing practical suggestions offered by clinical and research nurses from the Australian wound clinics.…”
Evidence translation in wound care relies on the need for evidence generation. Clinical practice may generate evidence only if evidence‐generating research projects, such as randomised controlled trials (RCTs), became routinised in clinical settings. The aim of this study was to identify optimal trial‐related practices to routinise trial‐related activities in Melbourne‐located wound clinics as reported by clinicians and researchers. We conducted a secondary analysis of the available data on how to routinise RCTs in clinical care, with a focus on enablers and suggestions provided by the participants during face‐to‐face and telephone interviews. Data were obtained from a qualitative observational study nested within a randomised, double‐blinded, placebo‐controlled trial on clinical effectiveness of aspirin as an adjunct to compression therapy in healing chronic venous leg ulcers (ASPiVLU). We developed a seven‐step Routinisation of Trials in Clinical Care Framework. These steps include: (1) pre‐trial clinical site assessment, (2) optimising pre‐recruitment arrangements, (3) developing and updating trial‐related skills, (4) embedding RCT recruitment as part of routine clinical care, (5) promoting teamwork and trial‐related collaboration, (6) addressing trial‐related financial issues, and (7) communicating trial results to clinicians.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
