학술논문

Selecting Outcomes to Ensure Pragmatic Trials Are Relevant to People Living with Dementia
Document Type
article
Source
Journal of the American Geriatrics Society. 68(S2)
Subject
Health Services and Systems
Health Sciences
Rehabilitation
Brain Disorders
Neurosciences
Comparative Effectiveness Research
Aging
Dementia
Acquired Cognitive Impairment
Neurodegenerative
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Clinical Trials and Supportive Activities
Alzheimer's Disease
Clinical Research
Neurological
Good Health and Well Being
Caregivers
Humans
National Institute on Aging (U.S.)
Patient Reported Outcome Measures
Pragmatic Clinical Trials as Topic
United States
dementia
Alzheimer's disease
patient-reported outcomes
pragmatic trial
Medical and Health Sciences
Geriatrics
Biomedical and clinical sciences
Health sciences
Psychology
Language
Abstract
Outcome measures for embedded pragmatic clinical trials (ePCTs) should reflect the lived experience of people living with dementia (PLWD) and their caregivers, yet patient- and caregiver-reported outcomes (PCROs) are rarely available in large clinical and administrative data sources. Although pragmatic methods may lead to use of existing administrative data rather than new data collected directly from PLWD, interventions are truly impactful only when they change outcomes prioritized by PLWD and their caregivers. The Patient- and Caregiver-Reported Outcomes Core (PCRO Core) of the IMbedded Pragmatic Alzheimer's Disease (AD) and AD-Related Dementias Clinical Trials (IMPACT) Collaboratory aims to promote optimal use of outcomes relevant to PLWD and their caregivers in pragmatic trials. The PCRO Core will address key scientific challenges limiting outcome measurement, such as gaps in existing measures, methodologic constraints, and burdensome data capture. PCRO Core investigators will create a searchable library of AD/AD-related dementias (ADRD) clinical outcome measures, including measures in existing data sources with potential for AD/ADRD ePCTs, and will support best practices in measure development, including pragmatic adaptation of PCROs. Working together with other Cores and Teams within the IMPACT Collaboratory, the PCRO Core will support investigators to select from existing outcome measures, and to innovate in methods for measurement and data capture. In the future, the work of the IMPACT Collaboratory may galvanize broader embedded use of outcomes that matter to PLWD and their care partners in large health systems. J Am Geriatr Soc 68:S55-S61, 2020.