衡量影响:对医疗影响评估的范围审查
L R Correia1,2, J C Martins3, E T Rother4
1Departamento de Medicina Preventiva da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil. lucas.reis.correia@usp.br.
这次范围审查对医疗保健中的影响评估进行了映射,发现大多数研究使用了强有力的比较方法,如反事实. 自然和准实验设计是最常见的,与指导方针保持一致,但显示了一些例外.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 证据综合 证据综合
背景情况:
- "影响评估"一词在医疗保健中越来越多地使用.
- 此前没有对这个主题进行全面的审查.
- 本研究解决了对医疗影响评估的全面概述的需求.
研究的目的:
- 绘制医疗影响评估中使用的可用证据和方法的地图.
- 进行关于医疗保健干预措施的同行评审研究的范围审查.
- 确定影响评估方法的趋势和常见做法.
主要方法:
- 进行了对同行评审研究的详尽范围审查.
- 包括医疗干预措施,没有语言或出版时间的限制.
- 在多个数据库中进行了搜索:Medline,Embase,Scopus,WoS和Econlit.
主要成果:
- 324项研究符合从4372个检索的注册表中包含的标准.
- 所有确定的研究都是事后评估.
- 大多数研究使用反事实 (58%),很少使用没有比较 (7%).
- 自然/准实验设计是最常见的 (37%),其次是观测 (26%) 和实验 (17%).
结论:
- 医疗影响评估主要采用强有力的比较方法 (反事实) 和设计,与指导方针一致.
- 虽然遵守指南是常见的,但在方法上存在例外和变化.
- 这些发现强调了在评估医疗保健干预影响时,强大的设计的普遍性.
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