临床预测规则.临床预测规则. 对方法标准的审查和建议修改
A Laupacis1, N Sekar, I G Stiell
1Department of Medicine, University of Ottawa, Ontario.
JAMA
|February 12, 1997
概括
这项研究审查了临床预测规则,发现它们往往缺乏明确的结果定义和前性验证. 为了更好的临床决策工具,需要改进方法.
科学领域:
- 临床流行病学临床流行病学
- 医疗信息学 医疗信息学
背景情况:
- 临床预测规则 (CPR) 是医疗保健专业人员必不可少的决策工具.
- 这些规则利用患者病史,体检结果和诊断测试结果.
研究的目的:
- 评估最近发表的临床预测规则的方法质量.
- 为开发和评估CPRs提出标准.
主要方法:
- 在1991年至1994年间出版的四个一般医学期刊中手动搜索CPR.
- 两个调查人员对30份符合条件的CPR报告进行了独立的质量评估.
- 达成共识,以解决质量评估中的分歧.
主要成果:
- 虽然大多数CPR在临床上是合理的 (97%),但对结果的明确定义 (83%) 和预测变量 (59%) 不太常见.
- 79%的研究报告了前性验证,但很少评估变量的可重复性 (3%) 和对临床使用的影响 (3%).
- 41%的规则被认为易于使用.
结论:
- 当前的临床预测规则符合一些方法标准,但需要改进其他标准.
- 加强对方法标准的遵守是强有力的CPR开发和评估所必需的.
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