Page 20 - 《中国药房》2024年23期
P. 20

6.6 优化患者知情同意机制                                           2022,111(1):135-144.
              传统的知情同意模式难以适应大数据时代的要求,                          [ 7 ]  LESKUR  D,BOZIC  J,RUSIC  D,et  al.  Adverse  drug
          应向动态机制转变,以确保患者能够全程控制其数据,                                 reaction  reporting  via  mobile  applications:a  narrative
                             [17]
          并获得前瞻性的保护 。主要模式有:(1)动态知情同                                review [J]. Int J Med Inform,2022,168:104895.
                                                              [ 8 ]  WICKS P,VAUGHAN T E,MASSAGLI M P,et al. Ac‐
          意。通过建立通信平台来支持实现个性化同意,促进研
                                                                   celerated  clinical  discovery  using  self-reported  patient
          究者和参与者之间持续的双向沟通。(2)泛知情同意。
                                                                   data collected online and a patient-matching algorithm[J].
          以研究对受试者的低风险性为基础,允许数据提供者在
                                                                   Nat Biotechnol,2011,29(5):411-414.
          初始同意时,授权其数据被用于未来的研究,而无需每
                                                              [ 9 ]  任燕,姚明宏,姚晨,等. 特许创新药械在博鳌乐城开展
          次研究都重新获得同意。(3)动态+泛知情同意。动态知                               真实世界数据研究的模式探索[J]. 中国食品药品监管,
          情同意可以弥补泛知情同意中受试者不能随时退出研                                  2020(11):14-20.
          究和研究过程不透明的不足。                                            REN Y,YAO M H,YAO C,et al. Exploration of frame‐
          6.7 建立药监部门与医保部门的证据协同机制                                   work  for  real  world  data  studies  on  special  innovative
              除了支持药品监管决策外,由 PED 产生的 RWE 还                          medical  products  in  Boao  lecheng[J].  China  Food  Drug
          可用于卫生技术评估,为医保支付范围的确定、卫生政                                 Adm Mag,2020(11):14-20.
          策的制定提供支持。考虑到在药物全生命周期中,PED                           [10]  SHEN  L  S,ZHOU  J,CHEN Y  D,et  al.  Treatment  pat‐
          可能被药监及医保部门多次测量,并有证据迁移的可能                                 terns,effectiveness,and patient-reported outcomes of pal‐
                                                                   bociclib therapy in Chinese patients with advanced breast
          性,因此有必要进一步探索部门之间的数据共享与证据
                                                                   cancer:a  multicenter  ambispective  real-world  study[J].
          协同机制,进而提高行政决策的效率。
                                                                   Cancer Med,2022,11(22):4157-4168.
          7 结语
                                                              [11]  XIAO Y ,XUE Z ,ZHANG Z,et al. Patient reported out‐
              PED将患者的需求、偏好和感受纳入RWS中,为药                             comes  of  vonoprazan  in  Chinese  reflux  esophagitis  pa‐
          物监管决策带来患者价值视角。目前,我国 PED 在                                tients:a  prospective  real-world  study[J]. Value  Health,
          RWS 中的应用尚处于起步阶段,面临数据标准不完善、                               2024,27(6):S48-S48.
          收集方法有限、数据治理能力不足等挑战。鉴于此,建                            [12]  张雯,黄青梅,黄跃师,等. 患者报告结局测量工具质量
          议结合我国国情,从政策框架、数据治理、技术创新等方                                评价标准的研究进展[J]. 护士进修杂志,2020,35(20):
          面发力,借鉴美国FDA等在PED应用方面的有效经验,                               1825-1830.
          推动建立涵盖数据收集、数据治理、数据整合、证据生                                 ZHANG W,HUANG Q M,HUANG Y S,et al. Research
          成、隐私保护的综合性指南框架,推动“以患者为中心”                                progress of quality evaluation criteria on tools for patient-
                                                                   reported  outcome  measures[J].  J  Nurses  Train,2020,35
          理念在我国药品监管体系中的深入应用。
          参考文献                                                    (20):1825-1830.
                                                              [13]  MEADOWS K A. Patient-reported outcome measures:an
          [ 1 ]  SHERMAN R E,ANDERSON S A,DAL PAN G J,et al.
                                                                   overview[J]. Br J Community Nurs,2011,16(3):146-151.
               Real-world evidence:what is it and what can it tell us?[J].
                                                              [14]  WIERING B,DE BOER D,DELNOIJ D. Patient involve‐
               N Engl J Med,2016,375(23):2293-2297.
                                                                   ment in the development of patient-reported outcome mea‐
          [ 2 ]  OBEN P. Understanding the patient experience:a concep‐
                                                                   sures:a scoping review[J]. Health Expect,2017,20(1):
               tual framework[J]. J Patient Exp,2020,7(6):906-910.  11-23.
          [ 3 ]  WOLF J A ,NIEDERHAUSER V ,MARSHBURN D ,
                                                              [15]  FDA. Qualification  process  for  drug  development  tools
               et al. Defining patient experience[J]. Patient Exp,2014,1  guidance  for  industry[EB/OL].(2020-11)[2024-05-10].
              (1):7-19.                                            https://www.fda.gov/media/133511/download.
          [ 4 ]  OEHRLEIN E M,SCHOCH S,BURCU M,et al. Deve-   [16]  ALBERT  W.  Users’guide  to  integrating  patient-reported
               loping  patient-centered  real-world  evidence:emerging   outcomes  in  electronic  health  records[EB/OL]. [2024-05-
               methods  recommendations  from  a  consensus  process[J].   10].https://www.pcori.org/sites/default/files/PCORI-JHU-
               Value Health,2023,26(1):28-38.                      Users-Guide-To-Integrating-Patient-Reported-Outcomes-in-
          [ 5 ]  TARDY A L,MARGUET S,COSTANTINO H,et al. Pro‐      Electronic-Health-Records.pdf.
               file  and  quality  of  life  of  the  adult  population  in  good   [17]  高志宏 . 大数据时代“知情-同意”机制的实践困境与制
               health according to the level of vitality:European NHWS   度优化[J]. 法学评论,2023,41(2):117-126.
               cross sectional analysis[J]. BMC Public Health,2023,23  GAO  Z  H.  Practical  dilemma  and  institutional  optimiza‐
              (1):1061.                                            tion  of “informed-consent”  mechanism  in  the  era  of  big
          [ 6 ]  PURPURA C A,GARRY E M,HONIG N,et al. The role     data[J]. Law Rev,2023,41(2):117-126.
               of  real-world  evidence  in  FDA-approved  new  drug  and   (收稿日期:2024-06-11  修回日期:2024-10-22)
               biologics  license  applications[J]. Clin  Pharmacol  Ther,                        (编辑:刘明伟)


          · 2850 ·    China Pharmacy  2024 Vol. 35  No. 23                            中国药房  2024年第35卷第23期
   15   16   17   18   19   20   21   22   23   24   25