核心等级2:选择确定性评级的目标,并评估不准确性
Gordon Guyatt1,2,3,4, Linan Zeng3,5,6,7,4, Romina Brignardello-Petersen8
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada guyatt@mcmaster.ca.
概括
本文解释了评价证据确定性的建议评估,开发和评估 (GRADE) 方法的核心分级. 它详细说明了如何根据最小重要的差异 (MID) 评估治疗效应,并为不精确性进行调整.
科学领域:
- 临床证据综合研究
- 卫生技术评估 卫生技术评估
- 医疗决策的制定 医疗决策的制定
背景情况:
- 建议评估,发展和评价 (GRADE) 框架的评级对于评估证据的确定性至关重要.
- 对证据确定性的准确评估为临床实践指南和医疗保健决策提供了信息.
研究的目的:
- 介绍用于确定性评级目标的核心等级方法.
- 概述证据确定性因不准确性而下调评级的方法.
主要方法:
- 核心GRADE用户评估治疗效应相对于最小重要差异 (MID) 的临床重要性.
- 与MID相关的效果点估计位置定义了确定性评估的目标.
- 如果影响估计的95%置信区间超过MID,证据确定性就会下降.
主要成果:
- 核心GRADE方法提供了一种系统的方法来评估治疗效果的重要性.
- 通过考虑信任区间与MID的重叠来解决不准确性,指导证据确定性的调整.
结论:
- 核心GRADE方法提供了一种标准化的方法来评估证据的确定性,重点是临床相关性和不精确性.
- 这种方法提高了在临床建议和决策中使用的证据的可靠性.
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