根据世界卫生组织的需求确定考科蓝评论的优先顺序：以抗精神病药物为例。
Using the needs of WHO to prioritise Cochrane reviews: The case of antipsychotic drugs.
机构信息
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy.
出版信息
Int J Ment Health Syst. 2011 Sep 24;5:25. doi: 10.1186/1752-4458-5-25.
BACKGROUND
This study aimed to investigate existing trialling activity relating to three antipsychotic drugs from the WHO List of Essential Medicines (chlorpromazine, fluphenazine decanoate, haloperidol), link existing trials to existing Cochrane reviews, identify gaps in reviewing activity on accessible treatments for people with schizophrenia.
METHODS
We used the Cochrane Schizophrenia Group's register searching for all studies comparing the three antipsychotic drugs with each other and with all other pharmacological interventions listed on the Essential Medicines List (with the addition of 'placebo or no drug'). For each we also considered studies that focussed on administration, dose, withdrawal and use of that drug in specific circumstances administration. Data were then extracted on a number of studies, number of participants within those studies, and as to whether a maintained review already exists. Finally, every effort was made to consider as to whether there were possibilities for missing comparisons that no one had ever investigated.
RESULTS
There has been considerable research activity involving the three 'essential' antipsychotics and also comparing those three drugs to others on the 'essential' list. We found 490 studies with 77957 participants for haloperidol, 316 studies with 29179 participants for chlorpromazine and 33 studies with 4503 participants for fluphenazine decanoate. Reviewing activity has also been considerable in this area but there are notable omissions which would necessitate new reviews to comprehensively cover the area.
CONCLUSIONS
We have used the 'sample frame' of the WHO Essential drug list as a starting point. WHO prioritises for us those drugs that have universal accessibility but they may not be the compounds that are first choice if others are available. It is encouraging to see how many maintained reviews already exist to service those undertaking WHO guidelines. The needs of those guiding care can be taken as a means of prioritising research. For largest global impact WHO Essential Medicine list provides clear direction. By using this technique workload can be anticipated, prioritising can take place for new reviews and updates.
背景
本研究旨在调查世界卫生组织基本药物清单（氯丙嗪、氟奋乃静癸酸酯、氟哌啶醇）中三种抗精神病药物的现有试验活动，将现有试验与现有的 Cochrane 评价联系起来，确定在精神分裂症患者可获得的治疗方法方面审查活动存在的差距。
方法
我们使用 Cochrane 精神分裂症组的登记处，搜索所有比较这三种抗精神病药物彼此以及与基本药物清单上列出的所有其他药物干预措施（加上“安慰剂或无药物”）的研究。对于每一种药物，我们还考虑了专门针对药物管理、剂量、停药和在特定情况下使用的研究。然后，我们提取了一些研究的数据，包括这些研究中的参与者数量，以及是否已经存在维持性评价。最后，我们尽力考虑是否有可能存在没有人研究过的缺失比较。
结果
这三种“基本”抗精神病药物的研究活动相当多，而且也将这三种药物与“基本”清单上的其他药物进行了比较。我们发现，氟哌啶醇有 490 项研究，涉及 77957 名参与者；氯丙嗪有 316 项研究，涉及 29179 名参与者；氟奋乃静癸酸酯有 33 项研究，涉及 4503 名参与者。该领域的审查活动也相当多，但存在明显的遗漏，需要新的审查来全面涵盖该领域。
结论
我们以世界卫生组织基本药物清单的“样本框架”为起点。世界卫生组织为我们确定了那些具有普遍可及性的药物，但如果有其他药物可用，它们可能不是首选药物。看到有多少维持性评价已经存在，为那些遵循世界卫生组织指南的人提供服务，这是令人鼓舞的。指导护理的需求可以作为优先考虑研究的一种手段。对于最大的全球影响，世界卫生组织基本药物清单提供了明确的方向。通过使用这种技术，可以预测工作量，为新的审查和更新确定优先级。
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