“N\u1ebfu b\u1ea1n tra t\u1ea5n d\u1eef li\u1ec7u \u0111\u1ee7 l\u00e2u, n\u00f3 s\u1ebd th\u00fa nh\u1eadn v\u1edbi b\u1ea1n b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec”- Ronald Coase <\/p><\/blockquote>\n\n\n\n
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L\u00fac vi\u1ebft v\u1ec1 th\u1ec3 lo\u1ea1i nghi\u00ean c\u1ee9u n\u00e0y, Th\u01b0\u01a1ng Library l\u00e0m ngay m\u1ed9t \u0111\u1ed9ng t\u00e1c l\u00e0 search Google (Vi\u1ec7t Nam) \u0111\u1ec3 xem c\u00f3 ai \u0111\u00e3 vi\u1ebft th\u00f4ng tin v\u1ec1 nghi\u00ean c\u1ee9u n\u00e0y ch\u01b0a. K\u1ebft qu\u1ea3 ch\u1ec9 c\u00f3 m\u1ed9t b\u00e0i thuy\u1ebft tr\u00ecnh d\u1ea1ng pdf v\u00e0 v\u00e0i t\u1eeb b\u00e0i vi\u1ebft c\u00f3 nh\u1eafc t\u1edbi nghi\u00ean c\u1ee9u n\u00e0y. Th\u01b0\u01a1ng Library ng\u1ea1c nhi\u00ean v\u00ec th\u1ea5y nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c hay nghi\u00ean c\u1ee9u \u0111\u1eddi th\u1ef1c (real world evidence) v\u1ed1n d\u0129 l\u00e0 th\u1ec3 lo\u1ea1i r\u1ea5t ph\u1ed5 bi\u1ebfn trong gi\u1edbi y khoa v\u00e0 m\u00ecnh g\u1eb7p kh\u00e1 nhi\u1ec1u \u0111i l\u00e0m. (Th\u01b0\u01a1ng Library search Google v\u00e0o th\u00e1ng 07\/2021 nh\u00e9). V\u1eady n\u00ean th\u1eadt c\u00f3 l\u1ed7i khi b\u1ecf qua nghi\u00ean c\u1ee9u n\u00e0y v\u00ec n\u00f3 \u0111\u01b0\u1ee3c xem nh\u01b0 m\u1ed9t m\u1ea3nh gh\u00e9p \u0111\u1ec3 ho\u00e0n thi\u1ec7n nh\u1eefng thi\u1ebfu s\u00f3t c\u1ee7a nghi\u00ean c\u1ee9u ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng (RCT).<\/p>\n\n\n\n
Do \u0111\u00f3, b\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u1ea5p cho b\u1ea1n m\u1ed9t c\u00e1i nh\u00ecn c\u01a1 b\u1ea3n v\u1ec1 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c l\u1ea7n l\u01b0\u1ee3t qua 5 ph\u1ea7n sau:<\/p>\n\n\n\n
1. V\u1ecb tr\u00ed trong th\u00e1p y h\u1ecdc ch\u1ee9ng c\u1ee9<\/u><\/strong>:<\/em><\/h3>\n\n\n\nN\u1ebfu b\u1ea1n n\u00e0o \u0111\u00e3 \u0111\u1ecdc b\u00e0i C\u00e1ch \u0111\u1ecdc nghi\u00ean c\u1ee9u khoa h\u1ecdc theo phong c\u00e1ch sinh vi\u00ean (ph\u1ea7n 2),<\/a><\/strong> ch\u1eafc h\u1eb3n \u0111\u00e3 th\u1ea5y Th\u01b0\u01a1ng Library \u0111\u1ec1 c\u1ea5p t\u1edbi t\u1ea5t t\u1ea7n t\u1eadt c\u00e1c lo\u1ea1i nghi\u00ean c\u1ee9u khoa h\u1ecdc. Nh\u01b0ng tuy\u1ec7t nhi\u00ean, Th\u01b0\u01a1ng Library ch\u01b0a nh\u1eafc t\u1edbi ch\u1ed7 c\u1ee7a nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c hay ch\u1ec9 r\u00f5 nghi\u00ean c\u1ee9u n\u00e0y n\u1eb1m \u1edf \u0111\u00e2u trong c\u00e1i Kim t\u1ef1 th\u00e1p danh gi\u00e1 \u1ea5y. V\u1eady r\u1ed1t cu\u1ed9c, ch\u1ed7 \u0111\u1ee9ng n\u00e0o Nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c trong Kim t\u1ef1 th\u00e1p Y h\u1ecdc th\u1ef1c ch\u1ee9ng?<\/p>\n\n\n\nS\u1ef1 th\u1eadt l\u00e0 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n v\u00e0o nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o ph\u01b0\u01a1ng ph\u00e1p lu\u1eadn (methodologies) v\u00e0 ngu\u1ed3n d\u1eef li\u1ec7u (data sources). \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c l\u00e0 t\u00ean g\u1ecdi chung<\/strong> cho m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u kh\u00e1c trong th\u00e1p ch\u1ee9ng c\u1ee9. N\u00f3 c\u00f3 th\u1ec3 l\u00e0 nghi\u00ean c\u1ee9u kh\u00f4ng can thi\u1ec7p (non-interventional studies), nghi\u00ean c\u1ee9u s\u1ed5 b\u1ed9, nghi\u00ean c\u1ee9u c\u01a1 s\u1edf d\u1eef li\u1ec7u thanh to\u00e1n ho\u1eb7c h\u00e0nh ch\u00ednh, kh\u1ea3o s\u00e1t b\u1ec7nh nh\u00e2n hay c\u00e1c nghi\u00ean c\u1ee9u h\u1ed3 s\u01a1 s\u1ee9c kh\u1ecfe \u0111i\u1ec7n t\u1eed. Ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh c\u00e1c nghi\u00ean c\u1ee9u ti\u1ec1n c\u1ee9u, th\u01b0\u1eddng y\u00eau c\u1ea7u thu th\u1eadp d\u1eef li\u1ec7u s\u01a1 c\u1ea5p (primary data) ho\u1eb7c nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u, s\u1eed d\u1ee5ng d\u1eef li\u1ec7u th\u1ee9 c\u1ea5p (secondary data) – t\u1ee9c l\u00e0 d\u1eef li\u1ec7u ban \u0111\u1ea7u \u0111\u01b0\u1ee3c thu th\u1eadp cho c\u00e1c m\u1ee5c \u0111\u00edch kh\u00e1c.1<\/sup><\/p>\n\n\n\n![\"\"](\"https:\/\/i0.wp.com\/thuonglibrary.com\/wp-content\/uploads\/2021\/07\/EBM-Pyramid.png?resize=546%2C410&ssl=1\")
<\/figure><\/div>\n\n\n\n2.<\/em> C\u00e1c kh\u00e1i ni\u1ec7m b\u1ed5 tr\u1ee3:<\/em><\/u><\/strong><\/h3>\n\n\n\nTr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u v\u00e0o t\u00ecm hi\u1ec3u v\u1ec1 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c, ch\u00fang m\u00ecnh c\u1ea7n n\u1eafm th\u00eam m\u1ed9t kh\u00e1i ni\u1ec7m li\u00ean quan m\u1eadt thi\u1ebft v\u1ec1 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c \u0111\u00f3 l\u00e0 d\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (real world data – RWD).<\/p>\n\n\n\n
D\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (RWD) <\/strong>l\u00e0 d\u1eef li\u1ec7u li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 \/ ho\u1eb7c vi\u1ec7c cung c\u1ea5p d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe \u0111\u01b0\u1ee3c thu th\u1eadp th\u01b0\u1eddng xuy\u00ean t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 th\u00f4ng b\u00e1o x\u00e1c nh\u1eadn quy\u1ec1n s\u1edf h\u1eefu v\u00e0 d\u1eef li\u1ec7u thanh to\u00e1n, s\u1ea3n ph\u1ea9m y t\u1ebf v\u00e0 s\u1ed5 \u0111\u0103ng k\u00fd b\u1ec7nh t\u1eadt, d\u1eef li\u1ec7u do b\u1ec7nh nh\u00e2n t\u1ea1o bao g\u1ed3m c\u1ea3 vi\u1ec7c s\u1eed d\u1ee5ng t\u1ea1i nh\u00e0 c\u00e0i \u0111\u1eb7t v\u00e0 d\u1eef li\u1ec7u thu th\u1eadp t\u1eeb c\u00e1c ngu\u1ed3n kh\u00e1c c\u00f3 th\u1ec3 th\u00f4ng b\u00e1o v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe (v\u00ed d\u1ee5: thi\u1ebft b\u1ecb di \u0111\u1ed9ng).2<\/strong><\/a><\/sup><\/p>\n\n\n\nC\u00e1c ngu\u1ed3n d\u1eef li\u1ec7u n\u00e0y th\u01b0\u1eddng l\u1ea5y t\u1eeb: 2,3<\/sup><\/strong><\/p>\n\n\n\n- H\u1ed3 s\u01a1 s\u1ee9c kh\u1ecfe \u0111i\u1ec7n t\u1eed (electronic health record)<\/li>
- C\u01a1 s\u1edf d\u1eef li\u1ec7u y\u00eau c\u1ea7u thanh to\u00e1n (reimbursement calaim data)<\/li>
- Nghi\u00ean c\u1ee9u s\u1ed5 b\u1ed9 (patient registries)<\/li>
- \u0110i\u1ec1u tra y t\u1ebf <\/li>
- Nghi\u00ean c\u1ee9u kh\u00f4ng can thi\u1ec7p (non – interventional studies)<\/li>
- C\u00e1c kh\u1ea3o s\u00e1t, \u0111i\u1ec1u tra d\u00e2n s\u1ed1 <\/li>
- D\u1eef li\u1ec7u t\u1eed vong (mortality data)<\/li>
- Data t\u1eeb c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n truy\u1ec1n th\u00f4ng<\/li>
- D\u1eef li\u1ec7u t\u1eeb c\u00e1c nh\u00e0 thu\u1ed1c (pharmacy data)<\/li>
- B\u1ea3o hi\u1ec3m s\u1ee9c kh\u1ecfe (health insurance)<\/li>
- \u2026<\/li><\/ol>\n\n\n\n
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Nghi\u00ean c\u1ee9u \u0111\u1eddi th\u1ef1c c\u00f3 ch\u1ea5t li\u1ec7u t\u1eeb c\u00e1c d\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c<\/figcaption><\/figure>\n\n\n\nNghi\u00ean c\u1ee9u RCT (ng\u1eabu nghi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng)<\/strong> \u2013 Trong thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u n\u00e0y, c\u00e1c c\u00e1 nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1eb1ng k\u0129 thu\u1eadt ng\u1eabu nhi\u00ean \u0111\u1eb7c bi\u1ec7t th\u00e0nh hai ho\u1eb7c nhi\u1ec1u nh\u00f3m, trong \u0111\u00f3 m\u1ed9t nh\u00f3m nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 can thi\u1ec7p (experimental) \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tra v\u00e0 nh\u00f3m kia kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c ho\u1eb7c can thi\u1ec7p ti\u00eau chu\u1ea9n. Ch\u1ec9 c\u00f3 nghi\u00ean c\u1ee9u RCT m\u1edbi ch\u1ec9 ra \u0111\u01b0\u1ee3c m\u1ed1i quan h\u1ec7 nh\u00e2n \u2013 qu\u1ea3 v\u00ec gi\u1ea3m \u0111\u01b0\u1ee3c s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a bias v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u. <\/p>\n\n\n\nTh\u1eed nghi\u1ec7m \u0111\u1ed1i ch\u1ee9ng ng\u1eabu nhi\u00ean b\u1ecb m\u00f9 \u0111\u00f4i l\u00e0 \u201cth\u1eed nghi\u1ec7m\u201d ho\u1eb7c thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u \u0111\u00e1ng tin c\u1eady nh\u1ea5t v\u00e0 cung c\u1ea5p s\u1ef1 h\u1ed7 tr\u1ee3 m\u1ea1nh m\u1ebd nh\u1ea5t cho m\u1ed1i quan h\u1ec7 nh\u00e2n qu\u1ea3. Tuy nhi\u00ean, nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y th\u01b0\u1eddng r\u1ea5t t\u1ed1n k\u00e9m v\u00e0 c\u00f3 th\u1ec3 c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 m\u1eb7t \u0111\u1ea1o \u0111\u1ee9c.<\/p>\n\n\n\n
Xem l\u1ea1i RCT t\u1ea1i b\u00e0i vi\u1ebft: https:\/\/thuonglibrary.com\/nghien-cuu-khoa-hoc\/cach-doc-mot-nghien-cuu-khoa-hoc-theo-phong-cach-sinh-vien-phan-2\/<\/a><\/p>\n\n\n\n![\"\"](\"https:\/\/i0.wp.com\/thuonglibrary.com\/wp-content\/uploads\/2021\/07\/high-view-diverse-wooden-characters-inclusion-concept.jpg?resize=840%2C473&ssl=1\")
Ch\u1ec9 c\u00f3 nghi\u00ean c\u1ee9u RCT m\u1edbi ch\u1ec9 ra \u0111\u01b0\u1ee3c m\u1ed1i quan h\u1ec7 nh\u00e2n \u2013 qu\u1ea3 v\u00ec gi\u1ea3m \u0111\u01b0\u1ee3c s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a bias v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u. <\/em><\/figcaption><\/figure>\n\n\n\n3. V\u1eady t\u00f3m l\u1ea1i <\/span>Nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c (RWE) l\u00e0 g\u00ec<\/u><\/strong><\/em><\/h3>\n\n\n\nC\u00e1c nghi\u00ean c\u1ee9u \u201cReal World Evidence\u201d l\u00e0 c\u00e1c nghi\u00ean c\u1ee9u l\u1ea5y d\u1eef li\u1ec7u l\u00e2m s\u00e1ng th\u1ef1c t\u1ebf g\u1ecdi l\u00e0 D\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (Real World Data) \u0111\u01b0\u1ee3c ghi nh\u1eadn trong qu\u00e1 tr\u00ecnh ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n, d\u00f9ng ph\u00e9p so s\u00e1nh th\u1ed1ng k\u00ea \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o lo\u1ea1i tr\u1eeb c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u trong qu\u00e1 tr\u00ecnh thu th\u1eadp m\u1eabu RWD. Nh\u1edd l\u1ea5y d\u1eef li\u1ec7u th\u1ed1ng k\u00ea t\u1eeb th\u1ef1c t\u1ebf, n\u00ean nghi\u00ean c\u1ee9u RWE ghi nh\u1eadn t\u00e1c d\u1ee5ng c\u00e1c c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch \u201c\u0111\u1eddi th\u1eadt\u201d nh\u1ea5t, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0a ra c\u00e1c so s\u00e1nh v\u1ec1 an to\u00e0n, hi\u1ec7u qu\u1ea3, chi ph\u00ed c\u1ee7a c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n
4. T<\/u><\/strong><\/em>\u1ea1i sao ch\u00fang ta c\u1ea7n c\u00f3 nghi\u00ean c\u1ee9u \u0111\u1eddi th\u1ef1c<\/em><\/u><\/strong><\/h3>\n\n\n\nCon ng\u01b0\u1eddi d\u00f9 \u01b0u t\u00fa \u0111\u1ebfn \u0111\u00e2u c\u0169ng s\u1ebd c\u00f3 nh\u1eefng \u01b0u nh\u01b0\u1ee3c \u0111i\u1ec3m v\u00e0 nghi\u00ean c\u1ee9u c\u0169ng v\u1eady. RCT lu\u00f4n \u0111\u01b0\u1ee3c xem l\u00e0 chu\u1ea9n m\u1ef1c v\u00e0ng, l\u00e0 con ngoan tr\u00f2 gi\u1ecfi \u0111\u1ec3 so s\u00e1nh v\u00e0 l\u1ea5y l\u00e0m b\u1eb1ng ch\u1ee9ng c\u1ea7m c\u00e2n n\u1ea9y m\u1ef1c cho nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c. \u1ede nghi\u00ean c\u1ee9u RCT, m\u1ed1i quan h\u1ec7 nh\u00e2n qu\u1ea3 gi\u1eefa li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00e0 hi\u1ec7u qu\u1ea3 hay t\u00ednh an to\u00e0n c\u1ee7a n\u00f3 \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n r\u00f5 r\u00e0ng. Tuy nhi\u00ean, \u0111i\u1ec3m m\u1ea1nh c\u1ee7a RCT l\u1ea1i ch\u00ednh l\u00e0 \u0111i\u1ec3m y\u1ebfu v\u00e0 l\u00e0 l\u00ed do c\u1ea7n s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a RWE. RCT v\u00ec l\u00e0 ti\u00eau chu\u1ea9n n\u00ean \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf r\u1ea5t ch\u1eb7t ch\u1ebd, h\u1ea1n ch\u1ebf nh\u1eefng t\u00e1c \u0111\u1ed9ng c\u1ee7a nh\u1eefng y\u1ebfu t\u1ed1 th\u1ef1c t\u1ebf t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n\n\n\n
Trong khi \u0111\u00f3, \u1edf m\u1ed9t di\u1ec5n bi\u1ebfn kh\u00e1c, c\u00e1c nghi\u00ean c\u1ee9u RWE bao g\u1ed3m c\u00e1c qu\u1ea7n th\u1ec3 b\u1ec7nh nh\u00e2n \u0111\u1ea1i di\u1ec7n h\u01a1n nhi\u1ec1u cho qu\u1ea7n th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc so v\u1edbi c\u00e1c nh\u00f3m RCT; ch\u00fang c\u00f3 th\u1ec3 c\u00f3 c\u1ee1 m\u1eabu r\u1ea5t l\u1edbn v\u00e0 c\u00f3 th\u1ec3 cung c\u1ea5p th\u00f4ng tin v\u1ec1 th\u1ef1c h\u00e0nh \u0111i\u1ec1u tr\u1ecb trong c\u00e1c nh\u00f3m d\u00e2n s\u1ed1 c\u1ee5 th\u1ec3 th\u01b0\u1eddng b\u1ecb lo\u1ea1i tr\u1eeb kh\u1ecfi RCT (v\u00ed d\u1ee5,<\/strong> b\u1ec7nh nh\u00e2n cao tu\u1ed5i ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy th\u1eadn). 4<\/sup><\/strong><\/p>\n\n\n\nRWE c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 t\u1ed5ng th\u1ec3 \u1edf c\u00e1c nh\u00f3m b\u1ec7nh nh\u00e2n v\u00e0 nh\u00f3m nguy c\u01a1 kh\u00e1c nhau, v\u00e0 v\u00ec ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong m\u1ed9t nh\u00f3m d\u00e2n s\u1ed1 kh\u00f4ng \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong m\u1ed9t khung th\u1eddi gian d\u00e0i n\u00ean c\u00f3 th\u1ec3 cung c\u1ea5p hi\u1ec3u bi\u1ebft s\u00e2u s\u1eafc v\u1ec1 \u0111\u1ed9c t\u00ednh, an to\u00e0n l\u00e2u d\u00e0i v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 hi\u1ebfm g\u1eb7p.<\/strong> 4<\/sup><\/strong><\/p>\n\n\n\nC\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 RWE \u00edt t\u1ed1n k\u00e9m h\u01a1n v\u00e0 ho\u00e0n th\u00e0nh nhanh h\u01a1n so v\u1edbi RCT, v\u00e0<\/strong> ch\u00fang c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c m\u00f4 h\u00ecnh \u0111i\u1ec1u tr\u1ecb tr\u00ean nhi\u1ec1u lo\u1ea1i k\u1ebft qu\u1ea3 h\u01a1n. C\u00e1c nghi\u00ean c\u1ee9u RWE c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c \u0111\u00e1nh gi\u00e1 v\u1ec1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, d\u1ecbch t\u1ec5 h\u1ecdc, g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt, c\u00e1c m\u00f4 h\u00ecnh k\u00ea \u0111\u01a1n, s\u1eed d\u1ee5ng ngu\u1ed3n l\u1ef1c y t\u1ebf v\u00e0 hi\u1ec7u qu\u1ea3 v\u1ec1 chi ph\u00ed. 4<\/sup><\/strong><\/p>\n\n\n\n5. <\/em>Nh\u1eefng h\u1ea1n ch\u1ebf ti\u1ec1m \u1ea9n c\u1ee7a RWE<\/em><\/u><\/strong><\/h3>\n\n\n\nTheo nh\u1eefng l\u00fd thuy\u1ebft c\u1ee7a Th\u00e1p y h\u1ecdc th\u1ef1c ch\u1ee9ng x\u01b0a nay, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p lu\u1eadn v\u00e0 thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u nh\u01b0 nguy c\u01a1 g\u00e2y nhi\u1ec5u v\u00e0 sai l\u1ec7ch \u0111\u00e3 ng\u0103n c\u1ea3n c\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t kh\u00f4ng ng\u1eabu nhi\u00ean (v\u1ed1n r\u1ea5t h\u1eefu \u00edch cho vi\u1ec7c \u0111\u00e1nh gi\u00e1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ho\u1eb7c can thi\u1ec7p y t\u1ebf m\u1edbi). Ch\u00ednh v\u00ec v\u1eady, ngay c\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf t\u1ed1t c\u0169ng s\u1ebd \u0111\u01b0\u1ee3c coi l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ea5p th\u1ea5p h\u01a1n so v\u1edbi m\u1ed9t RCT \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf k\u00e9m h\u01a1n. 5<\/sup><\/a><\/p>\n\n\n\nHi\u1ec7n t\u1ea1i, gi\u00e1 tr\u1ecb c\u1ee7a RWE \u0111\u00e3 \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5 h\u01a1n nhi\u1ec1u, v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u RWE hi\u1ec7n \u0111ang t\u1ea1o th\u00e0nh m\u1ed9t ph\u1ea7n quan tr\u1ecdng c\u1ee7a vi\u1ec7c \u0111\u00e1nh gi\u00e1 sau giai \u0111o\u1ea1n c\u1ea5p ph\u00e9p \u0111\u1ed1i v\u1edbi m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t, theo y\u00eau c\u1ea7u c\u1ee7a c\u00e1c c\u01a1 quan qu\u1ea3n l\u00fd. 5,6<\/sup><\/a> Tuy nhi\u00ean, v\u1eabn n\u00ean xem x\u00e9t c\u00e1c h\u1ea1n ch\u1ebf c\u00f3 th\u1ec3 x\u1ea3y ra. H\u1ea1n ch\u1ebf ch\u00ednh c\u1ee7a c\u00e1c nghi\u00ean c\u1ee9u RWE l\u00e0 thi\u1ebfu t\u00ednh ng\u1eabu nhi\u00ean. Khi kh\u00f4ng c\u00f3 y\u1ebfu t\u1ed1 ng\u1eabu nhi\u00ean, b\u1ea5t c\u1ee9 m\u1ed9t s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0o c\u0169ng kh\u00f4ng th\u1ec3 k\u1ebft lu\u1eadn \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n \u0111\u1ebfn t\u1eeb vi\u1ec7c can thi\u1ec7p<\/p>\n\n\n\nNgo\u00e0i ra, n\u1ebfu kh\u00f4ng c\u00f3 m\u00f4i tr\u01b0\u1eddng nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, c\u00f3 th\u1ec3 c\u00f3 \u00edt ho\u1eb7c kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a vi\u1ec7c thu th\u1eadp d\u1eef li\u1ec7u trong c\u00e1c nghi\u00ean c\u1ee9u RWE.<\/p>\n\n\n\n![\"\"](\"https:\/\/i0.wp.com\/thuonglibrary.com\/wp-content\/uploads\/2021\/07\/pexels-ketut-subiyanto-4473494.jpg?resize=840%2C521&ssl=1\")
Ch\u00ednh v\u00ec v\u1eady, ngay c\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf t\u1ed1t c\u0169ng s\u1ebd \u0111\u01b0\u1ee3c coi l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ea5p th\u1ea5p h\u01a1n so v\u1edbi m\u1ed9t RCT \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf k\u00e9m h\u01a1n. 5<\/sup><\/a> <\/em><\/figcaption><\/figure>\n\n\n\nT\u00e0i li\u1ec7u tham kh\u1ea3o<\/u><\/strong><\/p>\n\n\n\n\n- Camm AJ, Fox KAA. Strengths and weaknesses of \u2018real-world\u2019 studies involving non-vitamin K antagonist oral anticoagulants, Open Heart 2018<\/em>;5:e000788. doi:10.1136\/ openhrt-2018-000788<\/li>
- US Food and Drug Administration. Framework for FDA’s Real World Evidence Program <https:\/\/www.fda.gov\/downloads\/ScienceResearch\/SpecialTopics\/RealWorldEvidence\/UCM627769.pdf<\/a>> (2018).<\/li>
- Ramamoorthy<\/a> R, Huang<\/a> S M. What Does It Take to Transform Real-World Data Into Real-World Evidence? Clinical Pharmacology & Therapeutics 2019, <\/em>106 (1):10-18\/ https:\/\/doi.org\/10.1002\/cpt.1486<\/a><\/li>
- Cohen AT, Goto S, Schreiber K, et al<\/em>. Why do we need observational studies of everyday patients in the real-life setting? European Heart Journal Supplements 2015<\/em>;17: D2-D8.doi:10.1093\/eurheartj\/suv035<\/li>
- Barnish MS, Turner S. The value of pragmatic and observational studies in health care and public health. Pragmat Obs Res<\/em> 2017; 8:49\u201355.\/doi:10.2147\/POR.S137701<\/li>
- Milne CP, Cohen JP, Felix A, et al . Impact of postapproval evidence generation on the biopharmaceutical industry. Clin Ther<\/em> 2015; 37:1852\u20138.doi:10.1016\/j.clinthera.2015.05.514<\/li><\/ol>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"
“N\u1ebfu b\u1ea1n tra t\u1ea5n d\u1eef li\u1ec7u \u0111\u1ee7 l\u00e2u, n\u00f3 s\u1ebd th\u00fa nh\u1eadn v\u1edbi b\u1ea1n b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec”- Ronald Coase L\u00fac vi\u1ebft v\u1ec1 th\u1ec3 lo\u1ea1i nghi\u00ean c\u1ee9u n\u00e0y, Th\u01b0\u01a1ng Library l\u00e0m ngay m\u1ed9t \u0111\u1ed9ng t\u00e1c l\u00e0 search Google (Vi\u1ec7t Nam) \u0111\u1ec3 xem c\u00f3 ai \u0111\u00e3 vi\u1ebft th\u00f4ng tin v\u1ec1 nghi\u00ean … <\/p>\n","protected":false},"author":1,"featured_media":424,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"WB4WB4WP_MODE":"","WB4WP_PAGE_SCRIPTS":"","WB4WP_PAGE_STYLES":"","WB4WP_PAGE_FONTS":"","WB4WP_PAGE_HEADER":"","WB4WP_PAGE_FOOTER":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[11],"tags":[4,6],"class_list":["post-418","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nghien-cuu-khoa-hoc","tag-nghien-cuu","tag-study"],"yoast_head":"\n
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S\u1ef1 th\u1eadt l\u00e0 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n v\u00e0o nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o ph\u01b0\u01a1ng ph\u00e1p lu\u1eadn (methodologies) v\u00e0 ngu\u1ed3n d\u1eef li\u1ec7u (data sources). \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c l\u00e0 t\u00ean g\u1ecdi chung<\/strong> cho m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u kh\u00e1c trong th\u00e1p ch\u1ee9ng c\u1ee9. N\u00f3 c\u00f3 th\u1ec3 l\u00e0 nghi\u00ean c\u1ee9u kh\u00f4ng can thi\u1ec7p (non-interventional studies), nghi\u00ean c\u1ee9u s\u1ed5 b\u1ed9, nghi\u00ean c\u1ee9u c\u01a1 s\u1edf d\u1eef li\u1ec7u thanh to\u00e1n ho\u1eb7c h\u00e0nh ch\u00ednh, kh\u1ea3o s\u00e1t b\u1ec7nh nh\u00e2n hay c\u00e1c nghi\u00ean c\u1ee9u h\u1ed3 s\u01a1 s\u1ee9c kh\u1ecfe \u0111i\u1ec7n t\u1eed. Ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh c\u00e1c nghi\u00ean c\u1ee9u ti\u1ec1n c\u1ee9u, th\u01b0\u1eddng y\u00eau c\u1ea7u thu th\u1eadp d\u1eef li\u1ec7u s\u01a1 c\u1ea5p (primary data) ho\u1eb7c nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u, s\u1eed d\u1ee5ng d\u1eef li\u1ec7u th\u1ee9 c\u1ea5p (secondary data) – t\u1ee9c l\u00e0 d\u1eef li\u1ec7u ban \u0111\u1ea7u \u0111\u01b0\u1ee3c thu th\u1eadp cho c\u00e1c m\u1ee5c \u0111\u00edch kh\u00e1c.1<\/sup><\/p>\n\n\n\n Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u v\u00e0o t\u00ecm hi\u1ec3u v\u1ec1 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c, ch\u00fang m\u00ecnh c\u1ea7n n\u1eafm th\u00eam m\u1ed9t kh\u00e1i ni\u1ec7m li\u00ean quan m\u1eadt thi\u1ebft v\u1ec1 nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c \u0111\u00f3 l\u00e0 d\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (real world data – RWD).<\/p>\n\n\n\n D\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (RWD) <\/strong>l\u00e0 d\u1eef li\u1ec7u li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 \/ ho\u1eb7c vi\u1ec7c cung c\u1ea5p d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe \u0111\u01b0\u1ee3c thu th\u1eadp th\u01b0\u1eddng xuy\u00ean t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 th\u00f4ng b\u00e1o x\u00e1c nh\u1eadn quy\u1ec1n s\u1edf h\u1eefu v\u00e0 d\u1eef li\u1ec7u thanh to\u00e1n, s\u1ea3n ph\u1ea9m y t\u1ebf v\u00e0 s\u1ed5 \u0111\u0103ng k\u00fd b\u1ec7nh t\u1eadt, d\u1eef li\u1ec7u do b\u1ec7nh nh\u00e2n t\u1ea1o bao g\u1ed3m c\u1ea3 vi\u1ec7c s\u1eed d\u1ee5ng t\u1ea1i nh\u00e0 c\u00e0i \u0111\u1eb7t v\u00e0 d\u1eef li\u1ec7u thu th\u1eadp t\u1eeb c\u00e1c ngu\u1ed3n kh\u00e1c c\u00f3 th\u1ec3 th\u00f4ng b\u00e1o v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe (v\u00ed d\u1ee5: thi\u1ebft b\u1ecb di \u0111\u1ed9ng).2<\/strong><\/a><\/sup><\/p>\n\n\n\n C\u00e1c ngu\u1ed3n d\u1eef li\u1ec7u n\u00e0y th\u01b0\u1eddng l\u1ea5y t\u1eeb: 2,3<\/sup><\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n Nghi\u00ean c\u1ee9u RCT (ng\u1eabu nghi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng)<\/strong> \u2013 Trong thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u n\u00e0y, c\u00e1c c\u00e1 nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1eb1ng k\u0129 thu\u1eadt ng\u1eabu nhi\u00ean \u0111\u1eb7c bi\u1ec7t th\u00e0nh hai ho\u1eb7c nhi\u1ec1u nh\u00f3m, trong \u0111\u00f3 m\u1ed9t nh\u00f3m nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 can thi\u1ec7p (experimental) \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tra v\u00e0 nh\u00f3m kia kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c ho\u1eb7c can thi\u1ec7p ti\u00eau chu\u1ea9n. Ch\u1ec9 c\u00f3 nghi\u00ean c\u1ee9u RCT m\u1edbi ch\u1ec9 ra \u0111\u01b0\u1ee3c m\u1ed1i quan h\u1ec7 nh\u00e2n \u2013 qu\u1ea3 v\u00ec gi\u1ea3m \u0111\u01b0\u1ee3c s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a bias v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u. <\/p>\n\n\n\n Th\u1eed nghi\u1ec7m \u0111\u1ed1i ch\u1ee9ng ng\u1eabu nhi\u00ean b\u1ecb m\u00f9 \u0111\u00f4i l\u00e0 \u201cth\u1eed nghi\u1ec7m\u201d ho\u1eb7c thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u \u0111\u00e1ng tin c\u1eady nh\u1ea5t v\u00e0 cung c\u1ea5p s\u1ef1 h\u1ed7 tr\u1ee3 m\u1ea1nh m\u1ebd nh\u1ea5t cho m\u1ed1i quan h\u1ec7 nh\u00e2n qu\u1ea3. Tuy nhi\u00ean, nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y th\u01b0\u1eddng r\u1ea5t t\u1ed1n k\u00e9m v\u00e0 c\u00f3 th\u1ec3 c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 m\u1eb7t \u0111\u1ea1o \u0111\u1ee9c.<\/p>\n\n\n\n Xem l\u1ea1i RCT t\u1ea1i b\u00e0i vi\u1ebft: https:\/\/thuonglibrary.com\/nghien-cuu-khoa-hoc\/cach-doc-mot-nghien-cuu-khoa-hoc-theo-phong-cach-sinh-vien-phan-2\/<\/a><\/p>\n\n\n\n C\u00e1c nghi\u00ean c\u1ee9u \u201cReal World Evidence\u201d l\u00e0 c\u00e1c nghi\u00ean c\u1ee9u l\u1ea5y d\u1eef li\u1ec7u l\u00e2m s\u00e1ng th\u1ef1c t\u1ebf g\u1ecdi l\u00e0 D\u1eef li\u1ec7u \u0111\u1eddi th\u1ef1c (Real World Data) \u0111\u01b0\u1ee3c ghi nh\u1eadn trong qu\u00e1 tr\u00ecnh ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n, d\u00f9ng ph\u00e9p so s\u00e1nh th\u1ed1ng k\u00ea \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o lo\u1ea1i tr\u1eeb c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u trong qu\u00e1 tr\u00ecnh thu th\u1eadp m\u1eabu RWD. Nh\u1edd l\u1ea5y d\u1eef li\u1ec7u th\u1ed1ng k\u00ea t\u1eeb th\u1ef1c t\u1ebf, n\u00ean nghi\u00ean c\u1ee9u RWE ghi nh\u1eadn t\u00e1c d\u1ee5ng c\u00e1c c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch \u201c\u0111\u1eddi th\u1eadt\u201d nh\u1ea5t, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0a ra c\u00e1c so s\u00e1nh v\u1ec1 an to\u00e0n, hi\u1ec7u qu\u1ea3, chi ph\u00ed c\u1ee7a c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n Con ng\u01b0\u1eddi d\u00f9 \u01b0u t\u00fa \u0111\u1ebfn \u0111\u00e2u c\u0169ng s\u1ebd c\u00f3 nh\u1eefng \u01b0u nh\u01b0\u1ee3c \u0111i\u1ec3m v\u00e0 nghi\u00ean c\u1ee9u c\u0169ng v\u1eady. RCT lu\u00f4n \u0111\u01b0\u1ee3c xem l\u00e0 chu\u1ea9n m\u1ef1c v\u00e0ng, l\u00e0 con ngoan tr\u00f2 gi\u1ecfi \u0111\u1ec3 so s\u00e1nh v\u00e0 l\u1ea5y l\u00e0m b\u1eb1ng ch\u1ee9ng c\u1ea7m c\u00e2n n\u1ea9y m\u1ef1c cho nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c. \u1ede nghi\u00ean c\u1ee9u RCT, m\u1ed1i quan h\u1ec7 nh\u00e2n qu\u1ea3 gi\u1eefa li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00e0 hi\u1ec7u qu\u1ea3 hay t\u00ednh an to\u00e0n c\u1ee7a n\u00f3 \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n r\u00f5 r\u00e0ng. Tuy nhi\u00ean, \u0111i\u1ec3m m\u1ea1nh c\u1ee7a RCT l\u1ea1i ch\u00ednh l\u00e0 \u0111i\u1ec3m y\u1ebfu v\u00e0 l\u00e0 l\u00ed do c\u1ea7n s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a RWE. RCT v\u00ec l\u00e0 ti\u00eau chu\u1ea9n n\u00ean \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf r\u1ea5t ch\u1eb7t ch\u1ebd, h\u1ea1n ch\u1ebf nh\u1eefng t\u00e1c \u0111\u1ed9ng c\u1ee7a nh\u1eefng y\u1ebfu t\u1ed1 th\u1ef1c t\u1ebf t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n\n\n\n Trong khi \u0111\u00f3, \u1edf m\u1ed9t di\u1ec5n bi\u1ebfn kh\u00e1c, c\u00e1c nghi\u00ean c\u1ee9u RWE bao g\u1ed3m c\u00e1c qu\u1ea7n th\u1ec3 b\u1ec7nh nh\u00e2n \u0111\u1ea1i di\u1ec7n h\u01a1n nhi\u1ec1u cho qu\u1ea7n th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc so v\u1edbi c\u00e1c nh\u00f3m RCT; ch\u00fang c\u00f3 th\u1ec3 c\u00f3 c\u1ee1 m\u1eabu r\u1ea5t l\u1edbn v\u00e0 c\u00f3 th\u1ec3 cung c\u1ea5p th\u00f4ng tin v\u1ec1 th\u1ef1c h\u00e0nh \u0111i\u1ec1u tr\u1ecb trong c\u00e1c nh\u00f3m d\u00e2n s\u1ed1 c\u1ee5 th\u1ec3 th\u01b0\u1eddng b\u1ecb lo\u1ea1i tr\u1eeb kh\u1ecfi RCT (v\u00ed d\u1ee5,<\/strong> b\u1ec7nh nh\u00e2n cao tu\u1ed5i ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy th\u1eadn). 4<\/sup><\/strong><\/p>\n\n\n\n RWE c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 t\u1ed5ng th\u1ec3 \u1edf c\u00e1c nh\u00f3m b\u1ec7nh nh\u00e2n v\u00e0 nh\u00f3m nguy c\u01a1 kh\u00e1c nhau, v\u00e0 v\u00ec ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong m\u1ed9t nh\u00f3m d\u00e2n s\u1ed1 kh\u00f4ng \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong m\u1ed9t khung th\u1eddi gian d\u00e0i n\u00ean c\u00f3 th\u1ec3 cung c\u1ea5p hi\u1ec3u bi\u1ebft s\u00e2u s\u1eafc v\u1ec1 \u0111\u1ed9c t\u00ednh, an to\u00e0n l\u00e2u d\u00e0i v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 hi\u1ebfm g\u1eb7p.<\/strong> 4<\/sup><\/strong><\/p>\n\n\n\n C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 RWE \u00edt t\u1ed1n k\u00e9m h\u01a1n v\u00e0 ho\u00e0n th\u00e0nh nhanh h\u01a1n so v\u1edbi RCT, v\u00e0<\/strong> ch\u00fang c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c m\u00f4 h\u00ecnh \u0111i\u1ec1u tr\u1ecb tr\u00ean nhi\u1ec1u lo\u1ea1i k\u1ebft qu\u1ea3 h\u01a1n. C\u00e1c nghi\u00ean c\u1ee9u RWE c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c \u0111\u00e1nh gi\u00e1 v\u1ec1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, d\u1ecbch t\u1ec5 h\u1ecdc, g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt, c\u00e1c m\u00f4 h\u00ecnh k\u00ea \u0111\u01a1n, s\u1eed d\u1ee5ng ngu\u1ed3n l\u1ef1c y t\u1ebf v\u00e0 hi\u1ec7u qu\u1ea3 v\u1ec1 chi ph\u00ed. 4<\/sup><\/strong><\/p>\n\n\n\n Theo nh\u1eefng l\u00fd thuy\u1ebft c\u1ee7a Th\u00e1p y h\u1ecdc th\u1ef1c ch\u1ee9ng x\u01b0a nay, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p lu\u1eadn v\u00e0 thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u nh\u01b0 nguy c\u01a1 g\u00e2y nhi\u1ec5u v\u00e0 sai l\u1ec7ch \u0111\u00e3 ng\u0103n c\u1ea3n c\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t kh\u00f4ng ng\u1eabu nhi\u00ean (v\u1ed1n r\u1ea5t h\u1eefu \u00edch cho vi\u1ec7c \u0111\u00e1nh gi\u00e1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ho\u1eb7c can thi\u1ec7p y t\u1ebf m\u1edbi). Ch\u00ednh v\u00ec v\u1eady, ngay c\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf t\u1ed1t c\u0169ng s\u1ebd \u0111\u01b0\u1ee3c coi l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ea5p th\u1ea5p h\u01a1n so v\u1edbi m\u1ed9t RCT \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf k\u00e9m h\u01a1n. 5<\/sup><\/a><\/p>\n\n\n\n Hi\u1ec7n t\u1ea1i, gi\u00e1 tr\u1ecb c\u1ee7a RWE \u0111\u00e3 \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5 h\u01a1n nhi\u1ec1u, v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u RWE hi\u1ec7n \u0111ang t\u1ea1o th\u00e0nh m\u1ed9t ph\u1ea7n quan tr\u1ecdng c\u1ee7a vi\u1ec7c \u0111\u00e1nh gi\u00e1 sau giai \u0111o\u1ea1n c\u1ea5p ph\u00e9p \u0111\u1ed1i v\u1edbi m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t, theo y\u00eau c\u1ea7u c\u1ee7a c\u00e1c c\u01a1 quan qu\u1ea3n l\u00fd. 5,6<\/sup><\/a> Tuy nhi\u00ean, v\u1eabn n\u00ean xem x\u00e9t c\u00e1c h\u1ea1n ch\u1ebf c\u00f3 th\u1ec3 x\u1ea3y ra. H\u1ea1n ch\u1ebf ch\u00ednh c\u1ee7a c\u00e1c nghi\u00ean c\u1ee9u RWE l\u00e0 thi\u1ebfu t\u00ednh ng\u1eabu nhi\u00ean. Khi kh\u00f4ng c\u00f3 y\u1ebfu t\u1ed1 ng\u1eabu nhi\u00ean, b\u1ea5t c\u1ee9 m\u1ed9t s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0o c\u0169ng kh\u00f4ng th\u1ec3 k\u1ebft lu\u1eadn \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n \u0111\u1ebfn t\u1eeb vi\u1ec7c can thi\u1ec7p<\/p>\n\n\n\n Ngo\u00e0i ra, n\u1ebfu kh\u00f4ng c\u00f3 m\u00f4i tr\u01b0\u1eddng nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, c\u00f3 th\u1ec3 c\u00f3 \u00edt ho\u1eb7c kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a vi\u1ec7c thu th\u1eadp d\u1eef li\u1ec7u trong c\u00e1c nghi\u00ean c\u1ee9u RWE.<\/p>\n\n\n\n T\u00e0i li\u1ec7u tham kh\u1ea3o<\/u><\/strong><\/p>\n\n\n\n “N\u1ebfu b\u1ea1n tra t\u1ea5n d\u1eef li\u1ec7u \u0111\u1ee7 l\u00e2u, n\u00f3 s\u1ebd th\u00fa nh\u1eadn v\u1edbi b\u1ea1n b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec”- Ronald Coase L\u00fac vi\u1ebft v\u1ec1 th\u1ec3 lo\u1ea1i nghi\u00ean c\u1ee9u n\u00e0y, Th\u01b0\u01a1ng Library l\u00e0m ngay m\u1ed9t \u0111\u1ed9ng t\u00e1c l\u00e0 search Google (Vi\u1ec7t Nam) \u0111\u1ec3 xem c\u00f3 ai \u0111\u00e3 vi\u1ebft th\u00f4ng tin v\u1ec1 nghi\u00ean … <\/p>\n","protected":false},"author":1,"featured_media":424,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"WB4WB4WP_MODE":"","WB4WP_PAGE_SCRIPTS":"","WB4WP_PAGE_STYLES":"","WB4WP_PAGE_FONTS":"","WB4WP_PAGE_HEADER":"","WB4WP_PAGE_FOOTER":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[11],"tags":[4,6],"class_list":["post-418","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nghien-cuu-khoa-hoc","tag-nghien-cuu","tag-study"],"yoast_head":"\n<\/figure><\/div>\n\n\n\n2.<\/em> C\u00e1c kh\u00e1i ni\u1ec7m b\u1ed5 tr\u1ee3:<\/em><\/u><\/strong><\/h3>\n\n\n\n
3. V\u1eady t\u00f3m l\u1ea1i <\/span>Nghi\u00ean c\u1ee9u th\u1ebf gi\u1edbi th\u1ef1c (RWE) l\u00e0 g\u00ec<\/u><\/strong><\/em><\/h3>\n\n\n\n
4. T<\/u><\/strong><\/em>\u1ea1i sao ch\u00fang ta c\u1ea7n c\u00f3 nghi\u00ean c\u1ee9u \u0111\u1eddi th\u1ef1c<\/em><\/u><\/strong><\/h3>\n\n\n\n
5. <\/em>Nh\u1eefng h\u1ea1n ch\u1ebf ti\u1ec1m \u1ea9n c\u1ee7a RWE<\/em><\/u><\/strong><\/h3>\n\n\n\n