搜索ECRI指南 寻找基于证据的指南,解决种族和种族健康平等问题
Kelley N Tipton1, Danielle Mirda2, Anne Wert1
1ECRI, Plymouth Meeting, Pennsylvania (K.N.T., A.W.).
Annals of internal medicine
|October 27, 2025
概括
临床实践指南 (CPG) 往往未能充分整合种族和民族健康平等 (RHE). 虽然许多CPG承认RHE,但他们很少将其纳入建议或患者的不同观点.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生公平研究 卫生公平研究
- 临床实践指南开发 临床实践指南开发
背景情况:
- 临床实践指南 (CPG) 对基于证据的医疗保健至关重要.
- 在CPG中解决种族和民族健康平等 (RHE) 是减少健康差距的关键.
- 目前的CPG将RHE纳入到何种程度仍然不清楚.
研究的目的:
- 在ECRI指南信托 (EGT) 中审计CPG,以评估RHE的整合.
- 确定如何在CPG中解决RHE,包括基于种族的建议和多样化的患者观点.
- 总结RHE在CPG开发中的范围和背景.
主要方法:
- 从2020年1月到2025年1月,使用RHE相关术语对EGT进行了系统搜索.
- 包括美国组织为成年人群开发的基于系统审查的CPG.
- 包括的CPG和配套材料被审查以提取特征并总结关于RHE的发现.
主要成果:
- 在137个CPG中,有105个明确解决了RHE,主要是在实施或讨论部分 (78.1%).
- 较少将RHE纳入指导方法 (33.8%) 或建议 (39.7%),基于种族的建议很少 (0%) 但发现了证据差距 (22.8%).
- 大多数CPG描述了差异 (84.7%),很少有人将种族定义为社会结构 (20%),很少有人包括多样化的患者观点 (3.3%).
结论:
- 在CPG中对RHE的明确考虑往往仅限于实施,而不是核心方法或建议.
- 在将不同患者和公众观点纳入指南制定过程中存在重大差距.
- 需要进一步努力,在整个CPG开发过程中系统地整合RHE,以促进健康公平.
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