JAMA:美国心脏病学会/美国心脏学会临床实践指南Ⅰ类建议的耐用性

2014-06-16 马克·D ·纽曼等 美国费城宾夕法尼亚大学佩雷尔曼医学院麻醉 中国医学论坛报JAMA专版

意义:对于临床实践指南随时间延长的耐用性尚知之甚少。目的:了解美国心脏病学会/美国心脏学会(ACC/AHA)临床实践指南Ⅰ类建议(应当实施/采用的操作/治疗)耐用性发生变化的特征。  设计、场所和参与者:由4个独立的评审人对1998-2007年期间发布、2006-2013年期间修订的11部指南进行文本分析。 主要转归和检测指标:我们(找出)每部指南最近的2个版本,摘选第一个版本

意义:对于临床实践指南随时间延长的耐用性尚知之甚少。【原文下载】 目的:了解美国心脏病学会/美国心脏学会(ACC/AHA)临床实践指南Ⅰ类建议(应当实施/采用的操作/治疗)耐用性发生变化的特征。   设计、场所和参与者:由4个独立的评审人对1998-2007年期间发布、2006-2013年期间修订的11部指南进行文本分析。   主要转归和检测指标:我们(找出)每部指南最近的2个版本,摘选第一个版本中所有的一类建议,并在随后版本中找到相应的建议。我们对建议进行分类,对于被不太确定或相反建议取代的建议,我们将其归类为建议降级或逆转,而对于(随后的版本中)找不到相应条目的建议,我们将其归类为建议被省略。我们采用双变量模型假设检验和条件罗杰斯谛回归法,并根据指南主题和基础证据水平,来检验建议耐用性的差异。 (点击可放大) 结果:在619条索引建议中,有495条(80.0%,95%CI为76.6%~83.1%)在随后的指南版本中得以保留,有57条(9.2%,95%CI为7.0%~11.8%)被降级或逆转,有67条(10.8%,95%CI为8.4%~13.3%)被省略。在

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    2014-09-02 qblt
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