决策门对初级研究,证据综合和健康决策的许多作用
Holger J Schünemann1, Bernardo Sousa-Pinto2, Samuel G Schumacher3
1Clinical Epidemiology and Research Center, Humanitas University and IRCCS Humanitas Research Hospital, Pieve Emanuele, Milan, Italy; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Journal of clinical epidemiology
|November 28, 2025
概括
决策值 (DTs) 将判断从"没有益处"转变为"大益处",重点关注患者重要的结果,而不是统计学意义. 明确定义数据技术可以提高基于证据的决策的透明度和客观性.
科学领域:
- 临床决策的过程
- 证据综合研究
- 卫生政策 卫生政策
背景情况:
- 决策门 (DTs) 标志着判断改变的点,影响了替代方案之间的选择.
- 较小的统计显著效应可能缺乏临床意义,需要超过p值的值.
- 在指导方针中潜意识地应用DTs可以导致决策者之间的变化.
研究的目的:
- 在证据解释和合成中明确使用决策值 (DTs) 的优点.
- 强调DTs的好处,灵感来自最近的推评估,开发和评估 (GRADE) 工作组出版物.
主要方法:
- 讨论DTs在将重点从统计学意义转移到临床相关效应方面的作用.
- 解释DTs如何在GRADE方法中为证据评级提供确定性.
- 举例说明DT应用在评估不准确性和整合不同的研究证据.
主要成果:
- 数据技术为解释超出统计意义的结果提供了基础,提高了透明度和客观性.
- 在GRADE方法中,使用DTs来评估证据的确定性,评估不准确性,并整合来自不同类型研究的证据.
- 数据技术可以指导初级研究设计,包括针对特定效应大小的样本大小计算.
结论:
- 决策门在解释证据,评估确定性和规划研究方面起着至关重要的作用.
- 明确定义DT可以提高健康指南制定和决策的透明度,客观性和效率.
- 诊断技术专注于患者和决策者所关心的事情,从而使证据评估更加结构化和高效.
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