Studentlitteratur AB, Lund, Sweden.
Worldviews Evid Based Nurs. 2009;6(4):190-9. doi: 10.1111/j.1741-6787.2009.00160.x. Epub 2009 Jul 27.
This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Nursing Society (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident where such evidence was misunderstood by Swedish policy and health care decision makers.
This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe mental illness.
Systematic database searches in Medline, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-text documents, of which 5 were finally included and co-reviewed by two independent researchers.
The review found no decisive evidence of effectiveness regarding computer-based education programs designed to assist persons suffering from severe mental illness.
Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld, which at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.
本文是受瑞典医疗技术评估委员会（SBU）和瑞典护理协会（SSF）委托进行的研究报告。目的是对基于计算机的教育计划进行审查。但是，由于审查结果未能提供足够的有效性证据，该出版物被搁置，因为之前曾发生过瑞典政策制定者和医疗保健决策者误解此类证据的情况。
本文重点介绍了证据概念，即有效性证据不足被误认为是无效果证据的情况。目的还在于介绍一项针对患有严重精神疾病的患者的计算机教育计划的系统评价。
在 Medline、CINAHL、PsycINFO 和 Cochrane Library 中进行系统数据库检索，共确定了 131 篇潜在相关参考文献。随后，检索了 27 篇参考全文文献，其中 5 篇最终被纳入并由两位独立研究人员共同审查。
该综述未发现针对旨在帮助患有严重精神疾病的人设计的基于计算机的教育计划具有决定性的有效性证据。
未能看到有效性证据不足和无效果证据之间的区别可能会产生意想不到的后果。因此，实践可能会受到误导，治疗可能会被推迟，这在最坏的情况下可能对患者产生有害后果。最终，研究人员通过确保统计效力和结果测量质量来进行高质量的研究是至关重要的。例如，如果纳入的研究使用更复杂的设计，对计算机教育计划的这种审查可能会揭示出有效应对严重精神疾病的方法。
