循证医学证据质量分级与推荐系统

2016-10-26 MedSci MedSci原创

1. 定量系统评价证据分级工具(GRADE) 卫生系统中证据推荐分级的评估、制订与评价(The Grading of Recommendations Assessment, Development and Evaluation, GRADE)系统是当前证据质量和推荐强度分级的国际标准之一,由GRADE工作组于2004年正式推出,适用于临床实践指南、系统评价和卫生技术评估,最主要应用领域是临床实践

1. 定量系统评价证据分级工具(GRADE) 卫生系统中证据推荐分级的评估、制订与评价(The Grading of Recommendations Assessment, Development and Evaluation, GRADE)系统是当前证据质量和推荐强度分级的国际标准之一,由GRADE工作组于2004年正式推出,适用于临床实践指南、系统评价和卫生技术评估,最主要应用领域是临床实践指南。清楚的呈现纳入证据的质量并明确给出推荐意见分级的指南,不仅方法学质量更高,而且更有利于指南传播和应用。GRADE为系统评价和指南提供了一个证据质量评价的体系,同时为指南中的推荐强度评级提供了一种系统方法。需要注意的是,指南制定过程中形成推荐时,质量分级反映的是对效应估计值足以支持某决策或推荐的把握程度,这与系统评价中的证据质量分级反映的是对效应估计值正确的把握程度定义有所不同。 GRADE系统将证据质量分为“高、中、低和极低”四个等级,将推荐强度分为“强推荐和弱推荐”两个等级,并提供了用以描述的符号、字母或数字。具体见表1和表2。  GRADE方法中,证据质量分级始于研究设计,随

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2188434, encodeId=18f02188434b6, content=有参考价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:38:18 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=2188433, encodeId=8a47218843335, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:37:51 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=904801, encodeId=883190480168, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55d85441320, createdName=ZXYY-KJ, createdTime=Fri Dec 04 11:21:17 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890802, encodeId=ac8489080239, content=很有价值,如果能贴出参考文献就好了。 贴一篇我知道的参考文献(表1,表2的出处)——《如何正确理解及使用GRADE系统》曾宪涛等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c525424337, createdName=ms4000000657790849, createdTime=Fri Oct 09 16:02:16 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155492, encodeId=9557155492ef, content=基本明白。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b2a1732571, createdName= gospel007, createdTime=Sun Nov 13 15:55:13 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152232, encodeId=d23b152232ba, content=有参考價值!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/08/18cc28251093b78c00a4dabafc73bb9a.jpg, createdBy=6cff1969792, createdName=huaer9300, createdTime=Sun Oct 30 18:19:03 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379456, encodeId=155913e945607, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449706, encodeId=bcf21449e0695, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=)]
    2024-02-21 cqwenli94 来自重庆

    有参考价值

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2188434, encodeId=18f02188434b6, content=有参考价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:38:18 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=2188433, encodeId=8a47218843335, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:37:51 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=904801, encodeId=883190480168, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55d85441320, createdName=ZXYY-KJ, createdTime=Fri Dec 04 11:21:17 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890802, encodeId=ac8489080239, content=很有价值,如果能贴出参考文献就好了。 贴一篇我知道的参考文献(表1,表2的出处)——《如何正确理解及使用GRADE系统》曾宪涛等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c525424337, createdName=ms4000000657790849, createdTime=Fri Oct 09 16:02:16 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155492, encodeId=9557155492ef, content=基本明白。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b2a1732571, createdName= gospel007, createdTime=Sun Nov 13 15:55:13 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152232, encodeId=d23b152232ba, content=有参考價值!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/08/18cc28251093b78c00a4dabafc73bb9a.jpg, createdBy=6cff1969792, createdName=huaer9300, createdTime=Sun Oct 30 18:19:03 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379456, encodeId=155913e945607, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449706, encodeId=bcf21449e0695, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=)]
    2024-02-21 cqwenli94 来自重庆

    希望可以阅读全文

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2188434, encodeId=18f02188434b6, content=有参考价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:38:18 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=2188433, encodeId=8a47218843335, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:37:51 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=904801, encodeId=883190480168, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55d85441320, createdName=ZXYY-KJ, createdTime=Fri Dec 04 11:21:17 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890802, encodeId=ac8489080239, content=很有价值,如果能贴出参考文献就好了。 贴一篇我知道的参考文献(表1,表2的出处)——《如何正确理解及使用GRADE系统》曾宪涛等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c525424337, createdName=ms4000000657790849, createdTime=Fri Oct 09 16:02:16 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155492, encodeId=9557155492ef, content=基本明白。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b2a1732571, createdName= gospel007, createdTime=Sun Nov 13 15:55:13 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152232, encodeId=d23b152232ba, content=有参考價值!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/08/18cc28251093b78c00a4dabafc73bb9a.jpg, createdBy=6cff1969792, createdName=huaer9300, createdTime=Sun Oct 30 18:19:03 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379456, encodeId=155913e945607, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449706, encodeId=bcf21449e0695, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=)]
    2020-12-04 ZXYY-KJ

    希望可以阅读全文

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2188434, encodeId=18f02188434b6, content=有参考价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:38:18 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=2188433, encodeId=8a47218843335, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=67691637619, createdName=cqwenli94, createdTime=Wed Feb 21 08:37:51 CST 2024, time=2024-02-21, status=1, ipAttribution=重庆), GetPortalCommentsPageByObjectIdResponse(id=904801, encodeId=883190480168, content=希望可以阅读全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55d85441320, createdName=ZXYY-KJ, createdTime=Fri Dec 04 11:21:17 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890802, encodeId=ac8489080239, content=很有价值,如果能贴出参考文献就好了。 贴一篇我知道的参考文献(表1,表2的出处)——《如何正确理解及使用GRADE系统》曾宪涛等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c525424337, createdName=ms4000000657790849, createdTime=Fri Oct 09 16:02:16 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=155492, encodeId=9557155492ef, content=基本明白。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b2a1732571, createdName= gospel007, createdTime=Sun Nov 13 15:55:13 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152232, encodeId=d23b152232ba, content=有参考價值!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/08/18cc28251093b78c00a4dabafc73bb9a.jpg, createdBy=6cff1969792, createdName=huaer9300, createdTime=Sun Oct 30 18:19:03 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379456, encodeId=155913e945607, content=<a href='/topic/show?id=4f12504e147' target=_blank style='color:#2F92EE;'>#循证医学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50471, encryptionId=4f12504e147, topicName=循证医学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49cf452, createdName=xsm918, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449706, encodeId=bcf21449e0695, content=<a href='/topic/show?id=0bd850468be' target=_blank style='color:#2F92EE;'>#循证#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50468, encryptionId=0bd850468be, topicName=循证)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca95510093, createdName=xjy04, createdTime=Fri Oct 28 08:00:00 CST 2016, time=2016-10-28, status=1, ipAttribution=)]
    2020-10-09 ms4000000657790849

    很有价值,如果能贴出参考文献就好了。 贴一篇我知道的参考文献(表1,表2的出处)——《如何正确理解及使用GRADE系统》曾宪涛等。

    0

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    2016-11-13 gospel007

    基本明白。

    0

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    2016-10-30 huaer9300

    有参考價值!

    0

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    2016-10-28 xjy04

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