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临床实践指南中临床问题结构化分级及评价

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在指南制订临床问题构建环节,需要引导临床医生提出具备PICO(人群、干预、对照、结局)格式的临床问题或者对收集的临床问题进行PICO结构化处理.但PICO结构内部每个要素的宽窄限定与评价方法此前并没有被提出,导致具备了 PICO结构的临床问题由于范围宽窄不合适而仍旧不适合作为指南问题.本文根据PIC三个要素中明显需要拆分或扩充要素的数量将临床问题分为8个等级(3,2,1,0,-1,-2,-3,混合)以区分和评价临床问题的宽窄适用程度,并明确使用原则,为临床医生、指南制订者等提供方法学参考.
Structured grading and evaluation of clinical questions in clinical practice guidelines
In the process of guideline development and construction of clinical questions,it is necessary to guide clinicians to propose clinical problems into PICO(population,intervention,control,outcome)structured clinical questions.However,there are still unclear criteria to define and judge the appropriateness of the width of the PICO elements of a clinical question.Either too wide or too narrow can make the PICO question unsuitable to be a question for clinical practice guidelines to answer.We graded the clinical questions to be eight grades(3,2,1,0,-1,-2,-3,mixed)according to the number of the PIC elements,which obviously needed to be adjusted to evaluate applicability of the appropriateness of the width of the clinical questions.Our work can provide methodological references for clinicians and guideline developers.

Clinical questionPICOClinical practice guidelineMethodology

王雅琪、高一城、苏澄元、刘美君、李迅、费宇彤

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北京中医药大学循证医学中心(北京 100029)

北京中医药大学国际循证中医药研究院(北京 100029)

北京GRADE中心(北京 100029)

临床问题 PICO 临床实践指南 方法学

新疆维吾尔自治区重点研发计划项目

2021B03006-4

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(7)
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