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现有证据总结方法不能保证可信的患者决策辅助工具。

Existing evidence summarization methods cannot guarantee trustworthy patient decision aids.

机构信息

The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA.

Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.

出版信息

J Clin Epidemiol. 2018 Oct;102:69-77. doi: 10.1016/j.jclinepi.2018.06.003. Epub 2018 Jun 19.

Abstract

OBJECTIVES

Our aim was to evaluate how organizations that develop patient decision aids conduct their evidence summarization process and assess whether their current processes provide sufficient information to instill confidence that patient decision aids are trustworthy and up to date.

STUDY DESIGN AND SETTING

We identified 23 organizations from a public inventory of patient decision aid developers and included only organizations that have produced five or more tools. These organizations were asked to complete a 17-item survey and to share relevant documents.

RESULTS

Of the 23 organizations, 18 completed the survey, and 15 were eligible for analysis. Most organizations reported using existing systematic reviews and clinical practice guidelines. Seven of 15 had a documented approach for summarizing evidence, but the documents offered varying levels of detail. Common steps identified are tool-relevant question formation, search strategies, evidence appraisals, and updating policies.

CONCLUSIONS

Organizations do not use a standardized process to summarize evidence for the patient decision aids that they develop. This is problematic, given that the information they contain is known to influence patients' decisions. Further attention to how organizations summarize evidence for these tools is required.

摘要

目的

我们旨在评估开发患者决策辅助工具的组织如何进行证据总结过程,并评估其当前流程是否提供了足够的信息,以确保患者决策辅助工具是值得信赖且最新的。

研究设计和设置

我们从患者决策辅助工具开发者的公共清单中确定了 23 个组织,仅包括已生产 5 个或更多工具的组织。这些组织被要求完成一份 17 项的调查,并分享相关文件。

结果

在 23 个组织中,有 18 个完成了调查,其中 15 个符合分析条件。大多数组织报告使用现有的系统评价和临床实践指南。15 个中有 7 个组织有记录的证据总结方法,但文件提供的详细程度不同。确定的常见步骤包括与工具相关的问题形成、搜索策略、证据评估和更新政策。

结论

组织没有使用标准化的过程来总结他们开发的患者决策辅助工具的证据。这是有问题的,因为他们所包含的信息已知会影响患者的决策。需要进一步关注组织如何为这些工具总结证据。

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