3.3 使用建议

应采取有效措施增加我国对髋部骨折试验核心指标集的使用率。①增加护士、病人、统计学者等利益相关者的参与深度、广度，并联合该领域内各类专业人士制定一个较为有效的核心指标集[17]；②了解我国医学科研者对于标准化试验、核心指标集等的认识程度与使用现况，分析现有或潜在的问题并商讨对策；③采取多样化的宣传渠道提升相关人员对核心指标集项目的使用意识；④探索将该指标集应用于某一类试验中的可行性，如疼痛护理和外科康复等领域。

4 小结

本研究表明，我国注册的髋部骨折课题(或以此类病人为主要研究对象的试验)中大部分决定衡量汇报的结果项目里都没有包含本次研究的部分或全部核心指标集，一般都是以主观研究需求为主，内容不一。为了增加每项研究结果的价值，有必要进一步讨论其原因，并提高髋部骨折试验核心指标集的使用率。

[1] LEWIECKI E M,WRIGHT N C,CURTIS J R,etal.Hip fracture trends in the United States,2002 to 2015[J].Osteoporos Int,2018(29):717-722.

[2] GUAY J,PARKER M J,GRIFFITHS R, nerve blocks for hip fractures[J].Cochrane Database Syst Rev,2017(5):CD001159.

[3] COOPER C,CAMPION G,MELTON L J.Hip fractures in the elderly:a world-wide projection[J].Osteoporos Int,1992,2(6):285-289.

[4] SANZONE A challenges in pain management in hip fracture patients[J].J Orthop Trauma,2016,30(Suppl 1):S1-S5.

[5] O′DONNELL C M,BLACK N,MCCOURT K C, of a core outcome set for studies evaluating the effects of anaesthesia on perioperative morbidity and mortality following hip fracture surgery[J].Br J Anaesth,2019,122(1):120-130.

[6] GARGON E,GURUNG B,MEDLEY N, important health outcomes for comparative effectiveness research:a systematic review[J].PLoS One,2014,9(6):e.

[7] HAYWOOD K L,GRIFFIN X L,ACHTEN J, a core outcome set for hip fracture trials[J].Bone Joint J,2014(96):1016-1023.

[8] KIRKHAM J J,CLARKE M,WILLIAMSON P R.A methodological approach for assessing the uptake of core outcome sets using clinical :findings from a review of randomised con-trolled trials of rheumatoid arthritis[J].BMJ,2017,357:j2262.

[9] BARNES K L,KIRKHAM J J,CLARKE M, analysis did not provide a reliable assessment of core out-come set uptake[J].J Clin Epidemiol,2017(86):153-159.

[10] MYLES P S,GROCOTT M P,BONEY O, end points in perioperative trials:towards a core and extended outcome set[J].Br J Anaesth,2016(116):586-589.

[11] GORST S L,GARGON E,CLARKE M, important health outcomes for comparative effectiveness research:an updated review and user survey[J].PLoS One,2016,11(1):e0.

[12] ROBERTS K C,BROX W T,JEVSEVAR D S, of hip fractures in the elderly[J].J Am Acad Orthop Surg,2015,23(2):131-137.

[13] LU Y,UPPAL H S.Hip fractures:relevant anatomy,classification,and biomechanics of fracture and fixation[J].Geriatr Orthop Surg Rehabil,2019,10(11):.

[14] WILLIAMSON S,LANDEIRO F,MCCONNELL T, of fragility hip fractures globally:a systematic review and Meta-regression analysis[J].Osteoporos Int,2017,28(10):2791-2800.

[15] 毛贝尼,张钟,付维力,等.中国骨质疏松性骨折疾病负担的系统评价[J].中国循证医学杂志,2018,18(2):151-155.

[16] WILLIAMSON P R,ALTMAN D G,BAGLEY H,etal.The COMET handbook:version 1.0[J].Trials,2017,18(Suppl 3):280.

[17] SMITH T O,COLLITER T,SHEEHAN K J,etal.The uptake of the hip fracture core outcome set:analysis of 20 years of hip fracture trials[J].Age and Ageing,2019(10):1-4.

[18] KIRKHAM J J,DAVIS K,ALTMAN D G, outcome SET-Standards for development:the COS-STAD recommendations[J].PLoS Med,2017,14(11):e.

[19] KIRKHAM J J,GORST S,ALTMAN D G, outcome SET-Standards for reporting:the COS-STAD statement[J].PLoS Med,2016,13(10):e.

[20] GAGNIER J J,PAGE M J,HUANG H, of a core outcome set for clinical trials of people with shoulder pain:a study protocol[J].Trials,2017,18(1):336.

[21] MORRISON R S,DICKMAN E,HWANG U, nerve blocks improve pain and functional outcomes in hip fracture:a randomized controlled trial[J].J Am Geriatr Soc,2016,64(12):2433-2439.

[22] 齐海,丁悦,许杰,等.Harris评分和X线在评价全髋关节置换术后疗效中的作用[J].中华关节外科杂志(电子版),2009(4):444-448.

[23] 黎晓艳,童莺歌,陈佳佳,等.国外疼痛评估循证护理实践指南解读[J].护理学杂志,2017,32(16):14-17.

[24] COWAN R,LIM J H,ONG T,etal.The challenges of anaesthesia and pain relief in hip fracture care[J].Drugs Aging,2017(34):1-11.

[25] KLESTIL T,R?DER C,STOTTER C, of timing of surgery in elderly hip fracture patients:a systematic review and Meta-analysis[J].Sci Rep,2018,8(1):.

[26] DIZDAREVIC A,FARAH F,DING J,etal.A comprehensive review of analgesia and pain modalities in hip fracture pathogenesis[J].Curr Pain Headache Rep,2019,23(10):72.

[27] DYER S M,CROTTY M,FAIRHALL N,etal.A critical review of the long-term disability outcomes following hip fracture[J].BMC Geriatr,2016,16(1):158.

文章来源：《工程与试验》 网址: http://www.gcysyzz.cn/qikandaodu/2021/0730/2254.html