支持ACC/AHA和ESC急性冠状动脉综合征临床实践指南的证据类型
Maribel Gonzalez-Del-Hoyo1,2, Caterina Mas-Llado1,3,4, Laura Blaya-Peña2
1Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.
概括
对ST升高心肌梗塞 (STEMI) 和非ST升高急性冠状动脉综合征 (NSTE-ACS) 的临床指南在很大程度上依赖于非随机研究. 支持建议的研究类型因其证据水平而有很大差异.
科学领域:
- 心脏病学 心脏病学
- 临床实践指南 临床实践指南
- 基于证据的医学 基于证据的医学
背景情况:
- 对ST升高心肌梗塞 (STEMI) 和非ST升高急性冠状动脉综合征 (NSTE-ACS) 的临床实践指南对于医疗保健专业人员的决策至关重要.
- 评估这些指南的证据基础对于理解它们的稳定性至关重要.
研究的目的:
- 分析主要STEMI和NSTE-ACS临床指南中引用的研究类型.
- 评估不同类型的研究如何根据其证据水平支持指导方针建议.
主要方法:
- 从2013/2014年ACC/AHA和2017/2020年ESC指南中对STEMI和NSTE-ACS的参考和建议的审查.
- 将参考资料分类为元分析,随机研究,非随机研究和其他类型.
- 根据类别和证据水平 (LOE) 分类建议的分类.
主要成果:
- 非随机研究约占了支持指南的参考资料的45%.
- 分析和随机研究占总参考资料的不到三分之一.
- 支持推的研究类型的比例在不同的证据水平 (LOE-A,B和C) 上有很大差异.
结论:
- 在STEMI和NSTE-ACS指南中,很大一部分参考是非随机研究.
- 准则建议的证据基础是多样化的,并取决于指定的证据水平.
- 了解支指南的研究类型对于它们在临床实践中的适当应用至关重要.
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