GRADE guidelines: 13. Preparing Summary of Findings tables and evidence profiles-continuous outcomes
GRADE guidelines: 13. Preparing Summary of Findings tables and evidence profiles-continuous outcomes
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DOI：
10.1016/j.jclinepi.2012.08.001
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发表时间：
2013-02-01
影响因子：
7.2
通讯作者：
Schunemann, Holger J.
中科院分区：
文献类型：
--
作者：
Guyatt, Gordon H.;Thorlund, Kristian;Schunemann, Holger J.
在调查结果汇总表中呈现连续结果对解释提出了特别的挑战。当每项研究使用相同的结果指标，并且该指标的单位是直观可解释的（例如，住院时间、症状持续时间），通常希望在手段上存在差异。当结果测量的自然单位不容易解释时，选择一个阈值来创建二元结果并呈现相对和绝对效应成为一个更有吸引力的选择。当研究使用相同结构的不同测量时，计算汇总测量需要为每个研究转换为相同的测量单位。使用时间最长且最广泛的方法是将每项研究的平均值差异除以其标准差，并以标准差单位（标准化平均差）表示合并结果。这种方法的缺点包括易受潜在人群不同程度异质性的影响，以及难以解释。替代方案包括以最流行或可解释的测量单位呈现结果，转换为二分测量并呈现相对和绝对效果，呈现干预组和对照组的平均值比率，以及以最低重要差异单位呈现结果。我们概述了每种替代方案的优点和局限性，并为元分析师和指南开发人员提供指导。(C)2013 Elsevier Inc. All rights reserved.
Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences in means is usually desirable. When the natural units of the outcome measure are not easily interpretable, choosing a threshold to create a binary outcome and presenting relative and absolute effects become a more attractive alternative.When studies use different measures of the same construct, calculating summary measures requires converting to the same units of measurement for each study. The longest standing and most widely used approach is to divide the difference in means in each study by its standard deviation and present pooled results in standard deviation units (standardized mean difference). Disadvantages of this approach include vulnerability to varying degrees of heterogeneity in the underlying populations and difficulties in interpretation. Alternatives include presenting results in the units of the most popular or interpretable measure, converting to dichotomous measures and presenting relative and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers. (C) 2013 Elsevier Inc. All rights reserved.