Ukruthakruthwano phakathi kophando lwakudala noluyilayo
Injongo yayikukukhusela iOMT kumbono weqela kunye netonela .ngokuphikisana okwakhayo kunye nohlalutyo olubalulekileyo.? Injongo yayikukukhusela iOMT kumbono weqela kunye netonela .ngokuphikisana okwakhayo kunye nohlalutyo olubalulekileyo., Injongo yayikukukhusela iOMT kumbono weqela kunye netonela .ngokuphikisana okwakhayo kunye nohlalutyo olubalulekileyo.? Ukuza kuthi ga ngoku, iiNgxowa-mali zezeMpilo eziBambisana kunye ne-Health Holland ziququzelele 2017 umbuzo phantsi kwegama 'Beter Gezond'. Bakhetha kwiqela labangaphezulu 40 I-Cooperative Health Funds kunye ne-Health Holland ziququzelela isicelo soku kwaye ukhethe kwiqela elingaphezulu, I-Cooperative Health Funds kunye ne-Health Holland ziququzelela isicelo soku kwaye ukhethe kwiqela elingaphezulu (I-Cooperative Health Funds kunye ne-Health Holland ziququzelela isicelo soku kwaye ukhethe kwiqela elingaphezulu|I-Cooperative Health Funds kunye ne-Health Holland ziququzelela isicelo soku kwaye ukhethe kwiqela elingaphezulu).
TvBM_TheoBreuersTimvdGeijn_LD_lr_20200226-1594: TvBM_TheoBreuersTimvdGeijn_LD_lr_20200226-1594
Injongo: Ixabiso lokuzihlola ngomonde
Amaqela ezigulane sele ezama ixesha elithile ukuba abe negalelo ekuchacheni kwabo ngendlela eyakhiweyo, kuquka ngamangenelelo azikhethele wona. Injongo yombutho kukuphuhlisa nokuvavanya inkqubo entsha yophando ngesibonelelo.
Izindululo ezibini ezinxulumeneyo ziyadibana apha: enye isuka kwi-AMC kwaye enye isuka kumbutho wezigulane MD|I-Cooperative Health Funds kunye ne-Health Holland ziququzelela isicelo soku kwaye ukhethe kwiqela elingaphezulu. I-Immunologist e-Amsterdam UMC Anje te Velde kunye nomlawuli we-MD|KUNYE noGaston Remmers: "Isindululo sethu esidibeneyo sibandakanya indlela ecwangcisiweyo 'yokufunda kwiintlanzi' kulwandle lwedatha kunye noqwalaselo olwenziwa ngabaguli mihla le malunga nempilo yabo.. Sagxininisa kubantu abanokudinwa okungapheliyo, nabo banezikhalazo zamathumbu. Elo liqela elikhulu labantu ekungekho nakuphi na ungenelelo olufumanekayo ngoku, ngelixa aba bantu bezama yonke into, umzekelo ukomeleza amajoni omzimba.”
URemmers uyaqhubeka: “Umgaqo oza kuqulunqwa kwafuneka wenze ukuba kuphuhliswe ulwazi oluhlangeneyo olusekwe kuvavanyo lwezempilo oluyilwe ngabemi. Aba bantu bathanda ukwazi kwaye bazama izinto. Nangona kunjalo, izazinzulu azikwazi ukusebenzisa uninzi lwale mifuniselo, kuba bafumana ukuchaneka kwezesayensi akwanelanga. Kwakhona, aba bemi abahambelani nolingo lwezonyango olungacwangciswanga, ngokuqhelekileyo kufuneka kwiimviwo ezininzi zonyango. Isiphumo sesokuba xa kusenziwa amangenelelo amaninzi asezantsi kunye noncedo olunokuba luncedo alumisi ithuba, ngoxa, kwelinye icala, abaguli beqhubeka nokungenelela okunokuba yingozi.”
Izigulane, abaphandi, abaphononongi bangaphandle kunye nabaxhasi-mali ke ngoko bayasamkela isindululo seprojekthi ngolangazelelo olukhulu, ulindelo luphezulu.
Iqela lifumana umsebenzi wokuvelisa ubungqina bombono: bonisa ukuba uphando olwenziwe ngabemi ngabanye malunga nempilo yabo aluboneleli nje kuphela ulwazi oluxabisekileyo kubo, kodwa nakuphuhliso lolwazi.
Okwangoku, i-consortium enkulu iye yavela, ixhaswa ngemali yi-Cooperative Dutch Health Funds kunye ne-Health Holland (isebe leSebe leMicimbi yezoQoqosho), kunye neengxowa-mali zezempilo ezisibhozo. Ikhonsortium ibandakanya amaziko emfundo amane (eAmsterdam UMC, KwiYunivesithi yaseUtrecht, IYunivesithi yaseAmsterdam kunye neYunivesithi yaseMaastricht), iinkampani ezintlanu (Winclove Probiotics B.V., Springfield Nutraceuticals, Iziko leMicrobiome, Biovis Diagnostics, Danone/Nutricia Research) kunye nemibutho emibini yabemi/yezigulane (Idatha yam iSiseko sethu seMpilo kunye ne-Holland Health Data Cooperative). Iprojekthi ineenkokeli ezimbini, yahlulwe phakathi kwezazinzulu kunye nezigulane: eAmsterdam UMC (inzululwazi) kunye neDatha yam iSiseko sethu seMpilo (izigulane). Iprojekthi ineBhodi yeeNgcali zeNzululwazi kunye neBhodi yeeNgcali zeZigulane. Ngamanye amazwi: inkxaso kunye nomdla kwiprojekthi iphezulu kakhulu.
"Besizithathele ingqalelo iiflegi ezibomvu ngaphambili."
Indlela: Isayensi yabemi njengokongeza kuphando lwakudala
I-MijnEigenOnderzoek iqala ngeqela elikhulu labantu abanokukhathala okungapheliyo kunye nezikhalazo zamathumbu.. Kuba kunzima ukubeka umnwe wakho kwindawo ebuhlungu, oogqirha abaninzi abazi ukuba benze ntoni ngezi zigulana. Okwangoku, aba bantu bahlala behamba nezikhalazo zabo iminyaka kwaye bazama yonke into, kuquka iiprobiotics. Kukho ubungqina obuqinileyo besayensi bokuthi umgangatho weflora yamathumbu unxulumene nokudinwa. Ukuza kuthi ga ngoku bekunzima ukuseka unxibelelwano olucacileyo, ngenxa yonxibelelwano oluninzi oluntsonkothileyo. Izifundo ze-Classic randomized kunye ne-placebo ezilawulwa ngoko ke aziboneleli ngomfanekiso ocacileyo. Kunzima kakhulu ukumisela i-avareji causality kunye nesiphumo, ngelixa abaphandi kwinqanaba lomntu bebona umahluko omkhulu kwiziphumo.
Ulingo oluqhelekileyo olulawulwa ngokungakhethiyo (Ii-RCT ze) zama ukunciphisa inani leefektha ezisebenzisanayo ukuya kwinani elilawulekayo nelisemgangathweni. Ngenxa yokuba iziphumo zezi zifundo zinika izigulane inzuzo encinci, I-MijnEigenOnderzoek iphakamisa enye imbono: vumela ubunzima bubekhona kwaye ubhale iiparamitha ezifanelekileyo. Ngaphakathi kule ndlela, injongo ayikho kakhulu ukubonelela ubungqina ngokukhawuleza ngesiphumo, iprojekthi ifuna indlela ecwangcisiweyo yokuvelisa iingcamango ezingcono zophando oluqinisekisayo lokulandela.
Ukuza kuthi ga ngoku, i-consortium icacisa le ndlela ngamanyathelo amathathu abalulekileyo:
inkqubo eyomeleleyo yokubeka iliso: abaphandi besigulana bakhetha ungenelelo phantsi kweliso likagqirha. Bachaza imilinganiselo yeziphumo ezifanelekileyo kwaye bazigcine kwi-app
uhlalutyo lwedatha ukuchonga ama-homogeneous subgroups ababizwa ngokuba ngabaphenduli kunye nabangabaphenduli
ulingo lweklasiki olungenamkhethe phakathi kwelinye lamacandelwana achongiweyo ukuchasa isiphumo esicingelwayo solunye ungenelelo
Oku kwenza ukuba indlela ivakale kwaye i-MijnEigenOnderzoek inikezela ubungqina obujoliswe kwindlela ekhuselekileyo yokuqhuba uphando ngongenelelo olukhethwa zizigulane kwaye zibeke iliso ngokwazo.. Umzekelo omangalisayo wesayensi yabemi.
Ngexesha lokucaciswa kobungqina bobungqina, kubonakala ngathi kumbono wezomthetho ukuhlolwa kwekomiti yokuhlaziywa kwezonyango. (ukuba igalelo kuphuhliso lolwazi lwezonyango kwaye ibonelela ngexabiso kwizigulana) iyimfuneko. Ikomiti isikhaba ngokuqinileyo isindululo sokuqala. Ukuqulunqa isindululo esihlaziyiweyo, iqela lizibandakanye kwiingxoxo nenye i-MREC, nto leyo engaqhelekanga. Uninzi lweeMETCs zisetyenziselwa ukufumana isindululo, ukugweba oko, nika impendulo kwaye yiloo nto. Le yindlela abazama ngayo ukubandakanya kunye nokubuza imibuzo kwi-METC. Izithinteli: “Besifuna ukuba bukhali ngencakuba: ukuba asifumani mvume, ubuncinane uvavanyo olubambekayo. “Siye sabuya nesiphakamiso esibukhali kakhulu sesibini. Siyingenise kwenye iMETC, kuba siye safumana uninzi lotata malunga nembono yesigulana kwi-MREC yokuqala. "
“Njengomphandi, musa ukoyika ukukhupha intamo yakho. Qhubeka: ubuncinane kubaguli.”
Iziphumo: Iimbono ezingahambelaniyo zibulala iMijnEigenResearch
Indima esesikweni ye-MREC ibonakala ingagungqi: Izithinteli: “Ekugqibeleni kuye kwafuneka ukuba sivumelane kwizinto ezimbini kuphela: okanye wenze i-RCT ecocekileyo kuyo, mhlawumbi ukhetha uphando loqwalaselo. Ngelixa sifuna ukwenza izinto ezintsha kule ndawo, siye sayila umxube.”
Nangona kunjalo, i-METC yesibini nayo iyayikhaba, ngenkuthazo ebanzi. "Siye safumanisa ngamandla ukuba ukuseta ngendlela etenxileyo ngokukhawuleza kuphakamisa imibuzo malunga necala leenqobo ezisesikweni,” uqhubeka uRemmers. “Siqale ngendlela eyahlukileyo yokuziphatha, nayo efuna indlela eyahlukileyo. Iimbono eziqhelekileyo malunga noku, nokuba ihlonipheke kangakanani na ngokwembono ye-MREC yomsebenzi, yamosha indlela yethu.”
Emva konyaka onesiqingatha, emva kwemigudu emibini eye yasilela ukufumana imvume kwiikomiti ezihlola imigaqo yezonyango, abaxhasi bezimali kunye namaqabane e-consortium bathatha isigqibo sokuyeka iprojekthi. Ukruthakruthwano phakathi kwamahlakani ekhonsortium kunye neekomiti zovavanyo lubonakalise lukhulu kakhulu. Abafumanana omnye komnye kwiimbono zabo kunye neenkxalabo malunga nokuziphatha, indlela yokusebenza kunye nempilo. Iprojekthi icinge ukuba ifumene indlela phakathi kweengcinga ezingahambelaniyo kumanqanaba amaninzi, kodwa wasilela ukodlula ii-paradoksi.
Emva kokuyeka, iMijnEigenOnderzoek ivelise iziphumo ezilungileyo ezimbini.
U-Anje Te Velde ufumene uhlahlo lwabiwo-mali kwi-UMC yase-Amsterdam ukuba atyumbe umphandi kuqeqesho. Ngoku uphanda ukukhathala kwi-IBD (ukudumba okungapheliyo kwamathumbu), apho abaphandi banikezela ngemibuzo kwizigulana ukujonga ukudinwa kwabo kwaye batsale igazi kuvavanyo lwe-immunological. Oku ke ngoko malunga nenkalo yophando lweMijnEigenOnderzoek. Isiphakamiso sophando ngoku samkelwe yiKomiti yezoNyango zezoNyango.
UGaston Remmers ngoku usebenza okwethutyana kwiDyunivesithi yaseTwente. Apho uphucula iimeko ezingqonge isayensi yabemi: ungaqhagamshela njani idatha kunye nophando 'kubantu abaphantsi' kunye neengcali kunye nexabiso kwaye ubandakanye amandla ophando abemi? Inxalenye yesabelo sakhe kukwenza nzulu ngakumbi inkqubo kunye neziphumo zeMijnEigenOnderzoek. Ukongeza, i-Agenda yoLwazi 'uPhando kunye neZigulana' yaqulunqwa phantsi kobunkokeli beDatha yam iSiseko seMpilo yethu., ngentsebenziswano neminye imibutho yezigulana egameni leZonMw. Ekugqibeleni, iCitizenScience2Health yazalwa, iqonga lesizwe lokuziphanda uluntu malunga nempilo malunga 15 amaqela ezigulane adibeneyo amele kunye 10.000 abantu.
Iziko leMicrobiome, elinye lamaqabane ekonsortium, uye wakha isiseko esitsha sonyango kunye nophando kwiziseko ezenze ingqondo yeMijnEigenOnderzoek. Iyeza lobuqu lihanjiswa apho, ngoluhlu lwehlabathi lwamacandelo eprobiotic, inxulunyaniswe nokujongwa komntu. Ngoku kukho ngaphezu 3000 izigulane eziphathwayo kwaye kukho ingxelo evumayo evela kwi-MREC ukusebenzisa idatha yophando olwenziwayo.
Ufundile izifundo: Inkcubeko engalawulekiyo malunga neendlela zokuziphatha kunye neendlela
Ukwandisa ulwamkelo kolu hlobo lophando, ingxoxo eqhubekayo phakathi kwabantu abafanelekileyo kunye nemibutho malunga nale miba iyafuneka. Ingqikelelo yophando oluyila kakhulu lweMijnEigenOnderzoek ineengcinga ezininzi ezimileyo malunga nendlela yokusebenza., Ukuziphatha kunye nokubandakanyeka kwesigulane kuphando ngokukhanya okutsha.
Kwangaxeshanye, ngekhe sazithatha ngqalelo iiflegi ezibomvu kwangethuba, kuba bebefika kwakusasa”, utshilo uTe Velde. “Ekuqaleni besele sifumene imiqondiso yokuba ikomiti yemigaqo yezonyango iyazibuza ukuba ingaba abantu kwi-AMC kufuneka bafune ukuthatha uxanduva 'lweendlela zokungakhathali'., oogqirha basekhaya kunye noogqirha. Izithinteli: “Iinjongo zethu yayikukulwa abantu abathi banolwazi lokunyanga kodwa bengenalo noogqirha basekhaya, oko kwenzeka nangona kunjalo, bonelela ngebhedi ekhuselekileyo. Sizicingele ngokugqithiseleyo kubuchule bethu bokujongana nesi silumkiso, bekufanele ukuba sizise ubuchwephesha obungcono kwakamsinyane.” UTe Velde wongeza kuloo nto: “Ngaxeshanye ndiyacinga ngoku: Njengomphandi, ungoyiki ukukhupha intamo yakho. Nokuba abantu bendawo bacinga ukuba asiyondawo yakho, qhubeka: ubuncinane kubaguli.”
Ukujonga ngasemva, uRemmers uthi: “Njengamahlakani eemanyano, besiyiqonda imingeni yenkqubo, kodwa sasilixabisa ithemba lokuba iprojekthi yethu inokudlula oko. Sabuqonda kakubi ubunzima kunye nobukhulu bayo, kwaye ngandlel’ ithile babengazi nto”.
“Indlela yeprojekthi ibisoloko ingena kwimiba yenkqubo. Oku kunento yokwenza nenkcubeko yophando kunye neembono ezisekiweyo malunga neendlela zokuziphatha kunye neendlela. Oku kuye kwabonakala ngathi akunakuvalwa ngexesha elinikiweyo kuphando. ”, utsho uRemmers.
Izithinteli: “Indlela kaMyEigenOnderzoek yayinombono, kodwa kwahamba ukuqonda, ngaphaya kobuchule kunye neeparadigms zamaqumrhu ovavanyo. Eyona nto ibalulekileyo ngoku kukufumana amanqaku esandanti ngaphezu kwetafile kwaye usebenze ngokuthe ngcembe. Oku kufuna intsebenziswano phakathi kwemibutho yezigulane, oorhulumente, izazinzulu kunye nabaxhasi bezimali bayimfuneko. ”
Inene kufuneka kubekho utshintsho kwindlela uZonMw, I-HealthHolland kunye namanye amaqela akhupha iifowuni zabo zophando. Izithinteli: “Kwiindlela ezintsha zokuziphatha, indlela yokusebenza kunye nempilo zidlala indima, akwanelanga ukuyila inkxaso-mali kwaye emva koko uxhomekeke kuhlaziyo lwamaqumrhu amiselweyo. Ezi ntlobo zeenkqubo ezintsha zifuna uvandlakanyo oluqhubekayo lwamanqaku okukhuhlana, ukukhawulezisa umjikelo wokufunda.”
Inqaku le-Einstein (jongana nobunzima): Bekunzima kangangeminyaka ukwenza nzima, ukuphanda amaqela ezigulane ahluke kakhulu. Ukungabikho kwemibono emitsha ekunyamekelweni kwala maqela ezigulane kuye kwabangela ukulungelelaniswa kwemibono phakathi kwemibutho ukusondela kuphando ngendlela entsha..
Kwi canyon (iipateni ezimiliselweyo): IKomiti yokuHlola iNdlela yokuziphatha yezoNyango (ukuba igalelo kuphuhliso lolwazi lwezonyango kwaye ibonelela ngexabiso kwizigulana) ibona i-RCTs njengegrail engcwele yophando lwenzululwazi apho uvavanyo lwezempilo lufanele lusekelwe khona. Ngelishwa, izigwebo ze-METC zazingekokwaphula nenkcubeko yophando lwangoku, ukomelela.
Indawo engenanto etafileni (asingawo onke amaqela achaphazelekayo abandakanyekayo): Imibutho ebandakanyekayo kwi-MijnEigenOnderzoek kunye neqela elikhokela le ntlangano, ayiphumelelanga ukuquka iMETC kwiprojekthi ekuqaleni. Nangona kunjalo, baye balawula into engaqhelekanga ngokutshintsha inkqubo yesiqhelo ye-METC ukusuka ekuvavanyeni izindululo ukuya ekudaleni ngokubambisana..
I-post-it (amandla enzondo): Ngelixa iqela elikhokelayo lenze izigqibo zamabhongo ezibe negalelo kwisiphumo esidanisayo, Ngaba amalungu eqela aba nemiphumo emibi emva kokumisa iMijnEigenOnderzoek?. Ngokomzekelo, izifundo ezimbini zenzululwazi ziqalwe ngamalungu eqela ngalinye kunye nale projekthi njengesizathu esithe ngqo.
