1.中国中医科学院中医临床基础医学研究所,北京市东城区东直门内南小街16号,100700
2.陕西省汉中市中医医院
3.北京市东城区社区卫生服务管理中心
liangning229@163.com
收稿:2023-08-09,
修回:2023-09-21,
纸质出版:2024-02-02
移动端阅览
胡紫腾,晏利姣,张钰菁等.中医药快速动态指南制定方法(三)——快速证据收集整合及推荐意见形成[J].中医杂志,2024,65(03):281-286.
HU Ziteng,YAN Lijiao,ZHANG Yujing,et al.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 3): Rapid Evidence Collection, Integration and Recommendation Formation[J].Journal of Traditional Chinese Medicine,2024,65(03):281-286.
胡紫腾,晏利姣,张钰菁等.中医药快速动态指南制定方法(三)——快速证据收集整合及推荐意见形成[J].中医杂志,2024,65(03):281-286. DOI: 10.13288/j.11-2166/r.2024.03.010.
HU Ziteng,YAN Lijiao,ZHANG Yujing,et al.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 3): Rapid Evidence Collection, Integration and Recommendation Formation[J].Journal of Traditional Chinese Medicine,2024,65(03):281-286. DOI: 10.13288/j.11-2166/r.2024.03.010.
缺乏高质量直接证据是中医药快速动态指南推荐意见形成过程中面临的一个重要问题,间接证据的补充是解决这一问题的关键途径。提出在证据收集过程中,应明确所需证据的类型,包括直接证据和间接证据,并通过设定“先直接,后间接”的证据筛选原则,规范并加速指南制定流程。建议在进行证据整合时,若直接证据充足,可直接形成推荐意见;当直接证据不足时,则需要通过整合间接证据来补充和完善推荐意见。此外,当证据体中包含多来源证据时,应遵循“就高不就低”的原则对证据进行评级。最后在形成推荐意见时,应将证据体级别、安全性、经济性等作为推荐强度的考量因素。
The lack of direct evidence is an important problem faced in the formation of recommendations in rapid living guidelines of traditional Chinese medicine under public health emergencies, and the supplementation of indirect evidence can be a key method to solve this problem. For the collection of evidence, the type of evidence required, including direct and indirect evidence, should be clarified, and ‘direct first’ principle for selecting evidence can be set to standardize and accelerate the guideline development. When integrating evidence, recommendations can be formed directly if there is sufficient direct evidence, while regarding insufficient direct evidence, recommendations need to be supplemented and improved by integrating indirect evidence. In addition, when the body of evidence contains evidence from multiple sources, it is suggested to rate the evidence according to “higher rather than lower” principle. Finally, when forming recommendations, the level of evidence, safety and economic efficiency should be taken into consideration to determine the strength of the recommendation.
BHAUMIK S . Use of evidence for clinical practice guideline development [J]. Trop Parasitol , 2017 , 7 ( 2 ): 65 - 71 .
王小琴 , 陈耀龙 , 杨楠 , 等 . 快速建议指南及其制定方法介绍 [J]. 中国循证医学杂志 , 2015 , 15 ( 9 ): 1103 - 1105 .
张迁 , 王琪 , 后亮瑛 , 等 . 动态指南制订方法及案例介绍 [J]. 中国循证医学杂志 , 2021 , 21 ( 4 ): 491 - 496 .
梁宁 , 陈雅馨 , 李慧珍 , 等 . 新型冠状病毒肺炎疫情下快速动态化制订循证中医指南的思考 [J]. 中国中西医结合杂志 , 2022 , 42 ( 2 ): 218 - 222 .
吕咪 , 黄金科 , 王凤云 , 等 . 结合“异病同治”治则探析功能性胃肠病症状重叠的治疗 [J]. 中医杂志 , 2022 , 63 ( 18 ): 1786 - 1788 .
National Institute for Health and Care Excellence . Deve-loping NICE guidelines: the manual [EB/OL]. ( 2014-10-31 )[ 2023-08-09 ]. http://www.nice.org.uk/process/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869 http://www.nice.org.uk/process/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869 .
SALIAN VS , WRIGHT JA , VEDELL PT , et al . COVID-19 transmission, current treatment, and future therapeutic strategies [J]. Mol Pharm , 2021 , 18 ( 3 ): 754 - 771 .
靳英辉 , 蔡林 , 程真顺 , 等 . 新型冠状病毒(2019-nCoV)感染的肺炎诊疗快速建议指南(完整版) [J]. 医学新知 , 2020 , 30 ( 1 ): 35 - 64 .
World Health Organization . WHO handbook for guideline development [M]. 2nd ed . Geneva : WHO Library , 2014 : 145 .
Scottish Intercollegiate Guidelines Network . Rapid guideline methodology: a guideline developer's handbook [EB/OL].( 2021-04-30 ) [ 2023-08-09 ]. https://www.sign.ac.uk/media/1836/20210408-rapid-guideline-manual-10.pdf https://www.sign.ac.uk/media/1836/20210408-rapid-guideline-manual-10.pdf .
MORGAN RL , FLOREZ I , FALAVIGNA M , et al . Development of rapid guidelines: 3. GIN-McMaster guideline development checklist extension for rapid recommendations [J]. Health Res Policy Syst , 2018 , 16 ( 1 ): 63 .
陈平雁 . 临床试验中样本量确定的统计学考虑 [J]. 中国卫生统计 , 2015 , 32 ( 4 ): 727 - 731,733 .
SHEA BJ , REEVES BC , WELLS G , et al . AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both [J]. BMJ , 2017 : j4008 . doi: 10.1136/bmj.j4008 http://dx.doi.org/10.1136/bmj.j4008 .
HIGGINS JPT , ALTMAN DG , GØTZSCHE PC , et al . The Cochrane collaboration's tool for assessing risk of bias in randomised trials [J]. BMJ , 2011 , 343 : d5928 . doi: 10.1136/bmj.d5928 http://dx.doi.org/10.1136/bmj.d5928 .
STANG A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses [J]. Eur J Epidemiol , 2010 , 25 ( 9 ): 603 - 605 .
GRADE工作组 . GRADE指南:Ⅲ .证据质量分级[J]. 中国循证医学杂志 , 2011 , 11 ( 4 ): 451 - 455 .
GRADE工作组 . GRADE指南:Ⅸ .证据质量升级[J]. 中国循证医学杂志 , 2011 , 11 ( 12 ): 1459 - 1463 .
国家卫生健康委员会 . 新型冠状病毒肺炎诊疗方案(试行第六版) [J]. 中国感染控制杂志 , 2020 , 19 ( 2 ): 192 - 195 .
中华人民共和国国务院新闻办公室 . 中国为全球应对疫情提供科学诊疗方案 [EB/OL]. ( 2020-03-25 ) [ 2023-08-09 ]. http://www.scio.gov.cn/xwfb/gwyxwbgsxwfbh/wqfbh_2284/ 2020n_4408/2020n03y26r/xgbdbj_4768/202208/t20220808_299308.html http://www.scio.gov.cn/xwfb/gwyxwbgsxwfbh/wqfbh_2284/2020n_4408/2020n03y26r/xgbdbj_4768/202208/t20220808_299308.html .
BROZEK JL , AKL EA , ALONSO-COELLO P , et al . Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions [J]. Allergy , 2009 , 64 ( 5 ): 669 - 677 .
李焕芹 , 邹忆怀 , 姚钰宁 , 等 . 古籍循证在中医临床实践指南制定中的应用 [J]. 中国循证医学杂志 , 2018 , 18 ( 2 ): 225 - 229 .
仝小林 , 李修洋 , 赵林华 , 等 . 从“寒湿疫”角度探讨新型冠状病毒肺炎的中医药防治策略 [J]. 中医杂志 , 2020 , 61 ( 6 ): 465 - 470,553 .
武汉大学中南医院新型冠状病毒肺炎防治课题组 . 新型冠状病毒肺炎(COVID-19)中西医结合临床诊疗快速建议指南 [J]. 中国研究型医院 , 2020 , 7 ( 2 ): 51 - 64 .
刘少南 . 基于GRADE构建中医干预类临床证据分级系统及应用研究 [D]. 广州 : 广州中医药大学 , 2021 .
姚钰宁 , 曹克刚 , 托托 , 等 . 基于专家问卷的中医古籍证据分级及推荐方法的构建 [J]. 中医杂志 , 2021 , 62 ( 7 ): 572 - 576 .
GUYATT G . 医学文献使用者指南:循证临床实践手册 [M]. 3版 . 刘晓清, 吴东, 费宇彤, 译. 北京 : 中国协和医科大学出版社 , 2019 : 478 .
NING L , YANFANG M , JINGYA W , et al . Traditional Chinese medicine guidelines for coronavirus disease 2019 [J]. J Tradit Chin Med , 2020 , 40 ( 6 ): 891 - 896 .
KONIARIS LG , DRUGAS G , KATZMAN PJ , et al . Management of gastrointestinal lymphoma [J]. J Am Coll Surg , 2003 , 197 ( 1 ): 127 .
RAGHU G , COLLARD HR , EGAN JJ , et al . An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management [J]. Am J Respir Crit Care Med , 2011 , 183 ( 6 ): 788 - 824 .
BATES SM , GREER IA , MIDDELDORP S , et al . VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines [J]. Chest , 2012 , 141 ( 2 Suppl ): e691 S-e736S.
BHASIN S , CUNNINGHAM GR , HAYES FJ , et al . Testosterone therapy in men with androgen deficiency syndromes: an endocrine society clinical practice guideline [J]. J Clin Endocr Metab , 2010 , 95 ( 6 ): 2536 - 2559 .
0
浏览量
9
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号