Ban Jong-Wook, Wallace Emma, Stevens Richard, Perera Rafael
Evidence-Based Health Care Programme, Centre for Evidence-Based Medicine, University of Oxford, Oxford, United Kingdom.
HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.
PLoS One. 2017 Jun 7;12(6):e0179102. doi: 10.1371/journal.pone.0179102. eCollection 2017.
BACKGROUND: Researchers should examine existing evidence to determine the need for a new study. It is unknown whether developers evaluate existing evidence to justify new cardiovascular clinical prediction rules (CPRs). OBJECTIVE: We aimed to assess whether authors of cardiovascular CPRs cited existing CPRs, why some authors did not cite existing CPRs, and why they thought existing CPRs were insufficient. METHOD: Derivation studies of cardiovascular CPRs from the International Register of Clinical Prediction Rules for Primary Care were evaluated. We reviewed the introduction sections to determine whether existing CPRs were cited. Using thematic content analysis, the stated reasons for determining existing cardiovascular CPRs insufficient were explored. Study authors were surveyed via e-mail and post. We asked whether they were aware of any existing cardiovascular CPRs at the time of derivation, how they searched for existing CPRs, and whether they thought it was important to cite existing CPRs. RESULTS: Of 85 derivation studies included, 48 (56.5%) cited existing CPRs, 33 (38.8%) did not cite any CPR, and four (4.7%) declared there was none to cite. Content analysis identified five categories of existing CPRs insufficiency related to: (1) derivation (5 studies; 11.4% of 44), (2) construct (31 studies; 70.5%), (3) performance (10 studies; 22.7%), (4) transferability (13 studies; 29.5%), and (5) evidence (8 studies; 18.2%). Authors of 54 derivation studies (71.1% of 76 authors contacted) responded to the survey. Twenty-five authors (46.3%) reported they were aware of existing CPR at the time of derivation. Twenty-nine authors (53.7%) declared they conducted a systematic search to identify existing CPRs. Most authors (90.7%) indicated citing existing CPRs was important. CONCLUSION: Cardiovascular CPRs are often developed without citing existing CPRs although most authors agree it is important. Common justifications for new CPRs concerned construct, including choice of predictor variables or relevance of outcomes. Developers should clearly justify why new CPRs are needed with reference to existing CPRs to avoid unnecessary duplication.
背景：研究人员应审查现有证据以确定是否需要开展一项新的研究。目前尚不清楚开发者是否会评估现有证据，以证明新的心血管临床预测规则（CPR）的合理性。 目的：我们旨在评估心血管CPR的作者是否引用了现有的CPR，部分作者未引用现有CPR的原因，以及他们认为现有CPR不足的原因。 方法：对来自国际初级保健临床预测规则登记处的心血管CPR的推导研究进行评估。我们审查了引言部分，以确定是否引用了现有的CPR。采用主题内容分析法，探究认定现有心血管CPR不足的既定原因。通过电子邮件和邮寄方式对研究作者进行调查。我们询问他们在推导时是否知晓任何现有的心血管CPR，他们如何搜索现有的CPR，以及他们是否认为引用现有CPR很重要。 结果：在纳入的85项推导研究中，48项（56.5%）引用了现有的CPR，33项（38.8%）未引用任何CPR，4项（4.7%）宣称没有可引用的CPR。内容分析确定了现有CPR不足的五类相关因素：（1）推导（5项研究；占44项的11.4%），（2）结构（31项研究；70.5%），（3）性能（10项研究；22.7%），（4）可转移性（13项研究；29.5%），以及（5）证据（8项研究；18.2%）。54项推导研究的作者（占所联系的76位作者的71.1%）回复了调查。25位作者（46.3%）报告称他们在推导时知晓现有的CPR。29位作者（53.7%）宣称他们进行了系统搜索以识别现有的CPR。大多数作者（90.7%）表示引用现有CPR很重要。 结论：心血管CPR的制定通常未引用现有的CPR，尽管大多数作者认为这很重要。新CPR常见的理由涉及结构，包括预测变量的选择或结局的相关性。开发者应参照现有CPR明确说明为何需要新的CPR，以避免不必要的重复。
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