Rapid randomized controlled trials have been surprisingly rare in health care quality improvement (QI) and systems interventions. Applying clinical trials methodology QI work brings two distinct fields together, applying the robustness of randomized controlled trials (RCTs) to the practical, operational learnings of the well-established QI field. Rapid trials also add a third element—speed—that enables health care systems to rapidly test multiple variations of an intervention in much the same way that A/B testing is done in the technology sector. When performed well, these rapid trials free researchers and health care systems from the requirement to be correct the first time (because it is low cost and quick to try something else) while offering a standard of evidence often absent in QI. Here we outline the historical underpinnings of this approach, provide guidance about how best to implement it, and describe lessons learned from running more than 20 randomized projects in the NYU Langone Health system.

中文翻译：

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利用快速随机试验改善医疗保健系统

在医疗保健质量改进 (QI) 和系统干预方面，快速随机对照试验非常罕见。应用临床试验方法 QI 工作将两个不同的领域结合在一起，将随机对照试验 (RCT) 的稳健性应用到成熟的 QI 领域的实际、可操作的学习中。快速试验还增加了第三个要素——速度——使医疗保健系统能够快速测试干预措施的多种变体，就像技术领域进行 A/B 测试一样。如果表现良好，这些快速试验可以使研究人员和医疗保健系统摆脱第一次就正确的要求（因为尝试其他方法成本低且速度快），同时提供 QI 中经常缺乏的证据标准。在这里，我们概述了这种方法的历史基础，提供了有关如何最好地实施该方法的指导，并描述了从纽约大学兰格尼健康系统中运行 20 多个随机项目中吸取的经验教训。