The Transplantation Society, Centre for Transplant and Renal Research, Millennium Institute, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.
Transplantation. 2010 Mar 27;89(6):644-5. doi: 10.1097/TP.0b013e3181d62f1b.
The clinical guideline for care of renal transplant recipients was written by a committee of 15 people from nine countries, supported by an evidence review team The scope of the review was care of the patient after a renal transplant-not evaluation or selection of recipients and donors, focusing on the issue specific to the immunosuppressed transplant patient. A total of 12,327 articles comprising 3168 randomized controlled trials, 7543 cohort studies, and 1609 reviews were selected by a formal search. Each article was formally evaluated for the quality of the data from A to D. A consistent set of statements were based on the strength of the evidence. Level 1 evidence: "we recommend" means that if you were a patient, most people would want to do this; if a clinician, you should recommend this course of action to most patients; and if a policy maker, you should adopt this as a reasonable standard. Level 2 evidence: "we suggest" means the majority of patients would want do this; to the clinician, it means that different solutions may well be needed for different patients; whereas to the health policy maker, this is a strong warning to engage stakeholders in the creation of a particular local policy. Because 69% of the advice is "suggested" on the basis of level C or D evidence, one outcome of this work is to make it clear where the current evidence for clinical decisions runs out of data.
该临床指南涵盖了 15 名来自 9 个国家的专家，由一个证据审查小组提供支持。该指南的范围是肾移植受者的护理，不包括受者和供者的评估或选择，重点是针对免疫抑制移植患者的具体问题。通过正式检索，共选择了 12327 篇文章，其中包括 3168 项随机对照试验、7543 项队列研究和 1609 项综述。对每篇文章进行了 A 至 D 级的正式数据质量评估。根据证据的强度，形成了一套一致的陈述。1 级证据：“我们建议”表示如果您是患者，大多数人希望这样做；如果您是临床医生，您应该向大多数患者推荐此方法；如果您是政策制定者，您应该将其作为合理的标准。2 级证据：“我们建议”表示大多数患者希望这样做；对于临床医生，这意味着不同的患者可能需要不同的解决方案；而对于卫生政策制定者，这是一个强烈的警告，要求利益相关者参与制定特定的当地政策。由于 69%的建议是基于 C 级或 D 级证据“建议”的，因此这项工作的一个结果是明确了临床决策的当前证据在何处缺乏数据。
