核心等级3:证据评估不一致性的评级确定性
Gordon Guyatt1,2,3, Stefan Schandelmaier4,5,6, Romina Brignardello-Petersen7
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada guyatt@mcmaster.ca.
本文介绍了Core GRADE方法,用于评估研究结果不同时的证据确定性. 它指导研究人员处理不一致性,以确保可靠的系统审查和建议.
科学领域:
- 基于证据的医学是基于证据的医学.
- 系统审查方法论 系统审查方法论
背景情况:
- 研究结果的不一致性可能会降低证据的确定性.
- 建议评估,发展和评价 (GRADE) 框架的分级解决了证据的确定性.
研究的目的:
- 介绍Core GRADE方法来评估证据确定性,当跨研究存在无法解释的变异性时.
- 提供一个系统的方法来处理系统审查中不一致的发现.
主要方法:
- 评估对二元结果的相对效应和连续结果的绝对效应的一致性.
- 开发先验假设来解释潜在的不一致性.
- 通过点估计差异和置信区间重叠来判断不一致的大小.
- 评估个别研究估计与预定义的门.
- 测试子组假设以解释异质性.
主要成果:
- 如果发现可信的子组效应,则为每个子组提供单独的证据摘要和确定性评级.
- 如果没有确定可信的子组效应,则提交一个单一的证据摘要,因不一致而降低潜在评级.
结论:
- 核心GRADE方法提供了一个结构化的方法来管理系统审查中的不一致性.
- 该方法旨在提高证据确定性评估的准确性和可靠性,从而产生更强有力的建议.
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