循证牙科与研究的有效性及适用性评估
[Evidence-based dentistry and rating the validity and applicability of research].
作者信息
Aartman I H A, van Loveren C
机构信息
Sociale Tandheelkunde en Voorlichtingskunde, Academisch Centrum Tandheelkunde Amsterdam.
出版信息
Ned Tijdschr Tandheelkd. 2007 Apr;114(4):166-71.
In order for a general dental practitioner to give a valid answer to a question asked according to the Problem-Intervention-Comparison-Outcome (PICO)-system, three questions need to be asked regarding validity, relevance and applicability of studies. The validity is determined by the position of the research on the ladder of evidence, and also by the assessment of the methodological quality of the study at stake. In this assessment, the study is rated on the basis of specific criteria.A randomized controlled trial for example can be assessed with regard to the randomisation procedure, blinding of patients, raters and treatment, and the number of patients lost for follow-up. In cohort studies and case-control studies the criteria on the basis of which an article can be assessed are the comparability of groups, the degree of independence among measurements, and the length and thoroughness of the follow-up. Furthermore, in all studies it is important that the quality of the measurement instruments is good. The assessment criteria for systematic reviews are a clear research question, a clearly written and repeatable search action for articles and an independent assessment of the methodological quality of the included articles. Finally, the general dental practitioner in determining applicability needs to pay attention to the sample and the type of patient used in the research.
为了让普通牙科医生根据问题-干预-对照-结果(PICO)系统对所提问题给出有效的答案,需要就研究的有效性、相关性和适用性提出三个问题。有效性由研究在证据阶梯上的位置决定,也由对相关研究方法质量的评估决定。在这种评估中,研究根据特定标准进行评分。例如,一项随机对照试验可根据随机化程序、患者、评估者和治疗的盲法以及失访患者数量进行评估。在队列研究和病例对照研究中,评估一篇文章所依据的标准是组间可比性、测量之间的独立程度以及随访的时长和全面性。此外,在所有研究中,测量工具的质量良好很重要。系统评价的评估标准是明确的研究问题、清晰撰写且可重复的文献检索行动以及对纳入文献方法质量的独立评估。最后,普通牙科医生在确定适用性时需要关注研究中使用的样本和患者类型。