CLINICAL-PREDICTION RULES - APPLICATIONS AND METHODOLOGICAL STANDARDS
CLINICAL-PREDICTION RULES - APPLICATIONS AND METHODOLOGICAL STANDARDS
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DOI：
10.1056/nejm198509263131306
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发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
GOLDMAN, L
中科院分区：
文献类型：
--
作者：
WASSON, JH;SOX, HC;GOLDMAN, L
临床预测规则的目的是通过定义如何使用临床发现进行预测来减少医疗实践中固有的不确定性。临床预测规则来自系统的临床观察。它们可以帮助医生识别需要诊断测试、治疗或住院治疗的患者。在采用预测规则之前，临床医生必须评估其对患者的适用性。我们描述的方法标准，可以用来决定是否预测规则是适合采用在临床医生的做法。我们将这些标准应用于33份预测规则的报告; 42%的报告包含了对预测规则、患者和临床环境的充分描述。只有34%的报告衡量了该规则的错误分类率，只有6%的报告描述了该规则对病人护理的影响。如果要充分实现临床预测规则的目标，作者和读者需要密切关注研究设计的基本原则。
The objective of clinical prediction rules is to reduce the uncertainty inherent in medical practice by defining how to use clinical findings to make predictions. Clinical prediction rules are derived from systematic clinical observations. They can help physicians identify patients who require diagnostic tests, treatment, or hospitalization. Before adopting a prediction rule, clinicians must evaluate its applicability to their patients. We describe methodological standards that can be used to decide whether a prediction rule is suitable for adoption in a clinician's practice. We applied these standards to 33 reports of prediction rules; 42 per cent of the reports contained an adequate description of the prediction rules, the patients, and the clinical setting. The misclassification rate of the rule was measured in only 34 per cent of reports, and the effects of the rule on patient care were described in only 6 per cent of reports. If the objectives of clinical prediction rules are to be fully achieved, authors and readers need to pay close attention to basic principles of study design.