JAMA:现行心血管疾病临床指南证据等级研究

2019-03-20 MedSci MedSci原创

研究发现,现行心血管疾病临床治疗指南中,仅少部分的推荐方案是依据多个或大型临床研究结论制定的,这一现象在近10年间无显著改善

理想的临床决策应基多个随机对照试验(RCT)的证据结果,但从过去来看,很少有临床指南建议完全基于这种类型的证据。近日研究人员就当前主要血管指南建议的证据类别和水平(LOE) 以及LOE随时间的变化进行了考察。

研究考察了美国心脏病学会/美国心脏协会(ACC/AHA)和欧洲心脏病学会(ESC)的临床指导文件(2008-2018年),以上述指南1999-2014的版本为参考,若指南依据多个临床研究或单一大规模临床研究则LOE定义为A,依据多个观察性研究或单一临床研究则定义为B,仅依据专家共识则定义为C。研究的主要终点是LOE A指南的比例。

总计考察了26个现行ACC/AHA指南,共2930项建议,其中248个建议LOE为A(8.5%),1465个建议为B(50.0%),1217个建议为C(41.5%)。总计考察25个现行ESC指南,共3399项建议,其中484个建议为A(14.2%),1053个建议为B(31.0%),1862个建议为C(54.8%)。与先前版本进行比较后发现,无论是ACC/AHA(现行vs先前,9.0% vs 11.7%)还是ESC(15.1% vs 17.6%)证据等级A的指南建议比例未见增加。

研究发现,现行血管疾病临床治疗指南中,仅少部分的推荐方案是依据多个或大型临床研究结论制定的,这一现象在近10年间无显著改善。

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    2019-06-10 jyzxjiangqin

    现行心血管疾病治疗。

    0

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    2019-05-29 jyzxjiangqin

    现行心血管疾病临床经验。

    0

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    2019-05-16 jyzxjiangqin

    现行心血管疾病临床治疗。

    0

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    2019-03-21 jyzxjiangqin

    心血管疾病临床经验。

    0

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    2019-03-20 12543c13m83暂无昵称

    谢谢分享

    0

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