Feasibility of effectiveness trials in pediatric anesthesia.

摘要: Effectiveness studies aim to investigate whether an intervention does more good than harm in normal clinical practice. Cochrane´s hierarchy of evidence incorporating efficacy, effectiveness and cost-effectiveness research provides a useful framework assess interventions are efficacious effective. The philosophy science model disease, illness, sickness can be used identify issues pediatric anesthetic constructively maps onto hierarchy. Historically anesthesia has concentrated on efficacy studies, which even if excellent design, tell us little about how generalizable or applicable routine practice the findings are. Simultaneously (illness perspective) (sickness been limited due systematic cultural factors. form middle rung hierarchy, between studies. determine work encourage patient centered outcomes, since outcomes that reflect priorities offer most generalizability. Identifying measuring challenges young children their developing consciousness communication. Due subjective nature experience illness despite difficulties elucidating those experiences from very young, patients should direct goals where possible. These not insurmountable increased emphasis is warranted. Sickness perspective research, terms cost effectiveness, remains underdeveloped anesthesia. Pediatric strong base but need expand include eventually ignored.