专业协会制定的实践指南:批判性评估的必要性
1Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. webmaster@assr.it
Lancet (London, England)
|February 16, 2000
概括
大多数专业协会的实践指南缺乏质量,很少有人报告利益相关者的参与,证据搜索或明确的建议分级. 虽然有所改善,但整体质量仍然不令人满意.
科学领域:
- 医学指导方针的制定和制定.
- 医疗服务研究 医疗服务研究
- 基于证据的医学是基于证据的医学.
背景情况:
- 人们越来越担心医疗实践指南的质量,可靠性和独立性.
- 缺乏关于专业协会制定的指导方针的方法质量数据.
研究的目的:
- 调查和评估专业协会开发的实践指南的方法质量.
- 在指南制定过程中发现常见的缺陷.
主要方法:
- 专业学会在同行评审期刊上发表的实践指南的系统审查 (1988-1998).
- 基于利益相关方参与的报告,证据搜索策略和建议的明确分级来评估指南的质量.
主要成果:
- 评估了431条指导方针;大多数指导方针未能满足质量标准.
- 利益相关者参与 (67%),证据搜索 (88%) 和建议分级 (82%) 的不报告率很高.
- 虽然搜索和分类显示随着时间的推移有所改善,但只有5%满足了所有三个质量标准.
结论:
- 专业协会的实践指南显示,尽管取得了一些改进,但方法质量并不令人满意.
- 需要共享明确的方法标准和共同的报告标准来制定指导方针.
- 建议推广类似于CONSORT声明的标准,以提高指南的质量.
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