在基于证据的医学中评估证据的确定性
Daniel A González-Padilla1, Philipp Dahm2
1Department of Urology, Clínica Universidad de Navarra, Madrid, Spain.
European urology focus
|October 23, 2023
概括
推,评估,发展和评价 (GRADE) 框架的评级有助于评估医学研究证据的确定性. 这种结构化的方法有助于临床医生做出明智的患者护理决策.
科学领域:
- 临床流行病学 临床流行病学
- 基于证据的医学基于证据的医学.
背景情况:
- 证据的确定性,先前的证据质量,衡量对临床实践指南效果估计的信心.
- 建议评级,评估,开发和评估 (GRADE) 框架提供了一种标准化的方法来评估证据的确定性.
研究的目的:
- 简要描述总结和赋予证据确定性评级的GRADE过程.
- 解释证据确定性如何影响临床实践指南建议.
主要方法:
- 在随机和非随机研究中,GRADE根据每个结果分配确定性级别 (高或低).
- 确定性级别根据包括偏差风险,不一致性,出版偏差,剂量反应梯度和效果大小在内的标准进行调整.
主要成果:
- 格雷德框架提供了一种可重复的方法来评估证据的确定性.
- 它允许根据特定研究特征对初始确定性评级进行系统调整.
结论:
- GRADE方法提高了临床实践指南中使用的证据的可靠性.
- 了解证据确定性使医疗保健专业人员和患者参与共享决策.
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