Rating the quality of evidence for clinical practice guidelines
Rating the quality of evidence for clinical practice guidelines
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DOI：
10.1016/0895-4356(96)00019-4
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发表时间：
1996-07-01
影响因子：
7.2
通讯作者：
Hicks, N
中科院分区：
文献类型：
--
作者：
Hadorn, DC;Baker, D;Hicks, N
本文描述了在卫生保健政策和研究资助的心力衰竭指南机构创建期间开发和使用的医疗证据质量评级系统。以往的证据评级方法并不是为临床实践指南的制定而设计的，目前的系统是基于这样一个原则，即研究设计中的缺陷严重到威胁到研究结果的有效性。基于这一原则，为随机对照试验、队列研究和医学登记研究开发了一种主要缺陷和次要缺陷的分类法。该系统的使用是在专家组审议的两个困难的临床问题的背景下描述的：冠状动脉血运重建的作用和美托洛尔的使用。
This article describes the system for rating the quality of medical evidence developed and used during creation of the Agency for Health Care Policy and Research-sponsored heart failure guideline. Previous approaches to rating evidence were not designed for use in the setting of clinical practice guidelines, The present system is based on the tenet that flaws in research design are serious to the extent they threaten the validity of the results of studies. A taxonomy of major and minor flaws based on that tenet was developed for randomized controlled trials and for cohort and medical registry studies. The use of the system is described in the context of two difficult clinical issues considered by the Panel: the role of coronary artery revascularization and the use of metoprolol.