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GRADE 指南:2. 提出问题并确定重要结局。

GRADE guidelines: 2. Framing the question and deciding on important outcomes.

机构信息

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Clin Epidemiol. 2011 Apr;64(4):395-400. doi: 10.1016/j.jclinepi.2010.09.012. Epub 2010 Dec 30.

Abstract

GRADE requires a clear specification of the relevant setting, population, intervention, and comparator. It also requires specification of all important outcomes--whether evidence from research studies is, or is not, available. For a particular management question, the population, intervention, and outcome should be sufficiently similar across studies that a similar magnitude of effect is plausible. Guideline developers should specify the relative importance of the outcomes before gathering the evidence and again when evidence summaries are complete. In considering the importance of a surrogate outcome, authors should rate the importance of the patient-important outcome for which the surrogate is a substitute and subsequently rate down the quality of evidence for indirectness of outcome.

摘要

GRADE 需要明确规定相关的设定、人群、干预措施和对照组。它还需要规定所有重要的结果——无论是否有研究证据可用。对于特定的管理问题,研究之间的人群、干预措施和结果应该足够相似,以至于可以推断出类似的效应幅度。指南制定者应在收集证据之前和证据摘要完成后再次规定结果的相对重要性。在考虑替代终点的重要性时,作者应评估替代终点所替代的患者重要结局的重要性,然后降低结果间接性的证据质量等级。

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