Ghui Roslyn, Bansal Jassimran Kaur, McLaughlin Catarina, Kotaska Andrew, Lokugamage Amali
a University College London Medical School, London, UK and.
b Department of Women's Health , University College London , Whittington Hospital , London , UK.
J Obstet Gynaecol. 2016 Jul;36(5):658-62. doi: 10.3109/01443615.2015.1110121. Epub 2016 Mar 25.
Clinical practice guidelines hope to offer unbiased, evidence-based guidance for clinicians. This paper examines levels of evidence contained within the guidelines of the Society of Obstetricians and Gynaecologists of Canada and compares classification of the recommendation (CoR) A/B/C/D/E/L (derived from evidence and consensus) versus quality of evidence assessment (QoEA) I-III. 1250 recommendations were analysed and 43% of recommendations were graded as "good" evidence, the highest grade of CoR, while just 24.6% of recommendations were based on the highest level of QoEA (level I). The paper discusses possible reasons for this discrepancy. The authors hope that this analysis promotes greater transparency in evidence-based medicine ultimately leading to using the best quality of evidence available yet taking into account any areas of scientific uncertainty. This will enhance respectful care of patients, while taking into account their autonomy and furthering the cause of patient centre care.
临床实践指南旨在为临床医生提供公正、基于证据的指导。本文研究了加拿大妇产科医师协会指南中所包含的证据水平，并比较了推荐分类（CoR）A/B/C/D/E/L（源自证据和共识）与证据质量评估（QoEA）I-III级。分析了1250条推荐，其中43%的推荐被评为“良好”证据，这是CoR的最高等级，而只有24.6%的推荐基于QoEA的最高级别（I级）。本文讨论了这种差异的可能原因。作者希望该分析能提高循证医学的透明度，最终实现使用可得的最佳质量证据，同时考虑到任何科学不确定性领域。这将加强对患者的尊重性护理，同时考虑到患者的自主性，并推动以患者为中心的护理事业发展。
