证据与质量、实用性与判断：来自英国国家卫生与临床优化研究所的一些经验

Evidence and quality, practicalities and judgments: some experience from NICE.

作者信息

Culyer Anthony, Rawlins Michael

机构信息

Ontario Research Chair in Health Policy and System Design at the University of Toronto and is a professor of economics at the University of York, England.

Founding chair of the National Institute for Health & Clinical Excellence, president of the Royal College of Physicians of London, and professor emeritus at the University of Newcastle.

出版信息

Healthc Q. 2012;15 Spec No:66-9. doi: 10.12927/hcq.2012.23151.

DOI:10.12927/hcq.2012.23151

PMID:24863122

Abstract

The National Institute for Health and Clinical Excellence (NICE) is the principal provider of information about the evidence relating to effectiveness and cost-effectiveness in healthcare in the National Health Service of England and Wales. NICE regards quality as primarily to do with effectiveness, safety and the patient experience. In this paper we comment on the quality of evidence regarding these three and speculate about the consequences of widening the range of interventions for appraisal and taking more complete account of upstream determinants of health. We also comment on the type and quality of the evidence, as well as the way in which it is used, and the values--too often hidden--that permeate both the evidence and the way in which it is used.

摘要

英国国家卫生与临床优化研究所（NICE）是英格兰和威尔士国民医疗服务体系中有关医疗保健有效性和成本效益证据信息的主要提供者。NICE认为质量主要与有效性、安全性及患者体验相关。在本文中，我们对有关这三个方面的证据质量进行评论，并推测扩大评估干预措施范围以及更全面考虑健康上游决定因素的后果。我们还对证据的类型和质量、其使用方式以及贯穿于证据及其使用方式中常常被隐藏的价值观发表评论。