在中国卫生指南中识别可采取行动的陈述:一个横截面研究
Xiangying Ren1, Tamara Lotfi2,3, Jiyu Chen4
1Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
中国卫生指南的制定者经常错误地对建议进行分类,高估了正式的建议,低估了诸如良好实践陈述等可采取行动的陈述. 这凸显了需要提高健康指南中可操作内容的质量.
科学领域:
- 制定卫生政策和指导方针的制定.
- 基于证据的医学是基于证据的医学.
- 临床实践指南 临床实践指南
背景情况:
- 健康指南的质量和明确性对于有效的临床决策至关重要.
- 需要一个标准化的分类法来对健康指南中的不同类型的陈述进行分类.
- 了解陈述类型的分布可以揭示指导方针开发的改进领域.
研究的目的:
- 验证一项拟议的分类学和卫生指南中的陈述分类框架.
- 在中国卫生指南中识别和量化可起诉的陈述.
- 评估中国指南是否符合已确定的推标准.
主要方法:
- 在五个数据库的系统搜索中,确定了2020年1月至2023年5月期间发布的健康指南.
- 五位研究人员将指南声明分为六种类型:正式建议,良好实践声明 (GPS),评论,仅研究建议,实施考虑和非正式建议.
- 建议评估,开发和评估 (GRADE) 标准的分级也被评估为准则的遵守.
主要成果:
- 包括116条指导方针,其中大多数 (74) 是西方医学,其次是综合医学 (30) 和传统中医 (12).
- 医学专业协会是这些指南的主要制定者 (53.4%).
- 在4422份声明中,48.7%是正式的建议,而GPS (4.4%) 和实施考虑 (25.0%) 等可执行声明的频率低于预期,非正式的建议占12.6%.
结论:
- 中国的指导方针制定者倾向于高估正式建议,低估其他关键陈述类型.
- 在中国卫生指南中,有很大需要提高可起诉陈述的质量和准确性.
- 目前的分类学验证表明,在为临床实践制定实际和基于证据的建议方面存在差距.
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