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临床研究结果解读:如何评估临床研究结果的重要性(临床医师的实践指南)

A practitioner's guide to developing critical appraisal skills: How to interpret the magnitude of clinical study results.

出版信息

J Am Dent Assoc. 2023 Sep;154(9):836-841. doi: 10.1016/j.adaj.2023.06.005. Epub 2023 Jul 25.

Abstract

BACKGROUND

In the oral health literature, researchers sometimes report measures of association that are inappropriate for their study design. Clinicians using evidence to inform their practice should be able to interpret clinical study results on the basis of the types of measures of association, independent of what the researchers of a study reported.

TYPES OF STUDIES REVIEWED

The authors summarized which measures of association can be derived from experimental and observational studies and how to interpret them in the context of different study designs. They also suggested how inferences can be made on the basis of particular designs.

RESULTS

Measures of association derived from randomized controlled trials and cohort studies differ from those of case-control and cross-sectional studies. These differences can be attributed to the temporality between exposures and outcomes inherent in the respective study designs. Different measures of association reported from the same study may lead to different clinical decisions. Furthermore, the same measure of association with the same effect estimate derived from different study designs may contribute to different clinical decisions.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Measures of association should be interpreted in the context of a particular study design. Study designs and specific measures of association should be considered when drawing conclusions from clinical studies. Clinicians using the literature to inform practice should be cognizant of measures of association reported for a particular study design and whether the authors have interpreted the measure of association correctly in the context of their chosen study design.

摘要

背景

在口腔健康文献中,研究人员有时会报告与其研究设计不匹配的关联度衡量指标。临床医生在实践中应用证据时,应该能够根据关联度衡量指标的类型来解读临床研究结果,而无需参考研究人员的报告。

研究类型综述

作者总结了可以从实验和观察性研究中得出哪些关联度衡量指标,以及如何在不同的研究设计背景下解释这些指标。他们还提出了如何根据特定的设计进行推断。

结果

随机对照试验和队列研究得出的关联度衡量指标与病例对照和横断面研究不同。这些差异可归因于各自研究设计中暴露与结局之间固有的时间性。同一研究报告的不同关联度衡量指标可能会导致不同的临床决策。此外,同一研究设计得出的相同关联度衡量指标和相同的效果估计值也可能会导致不同的临床决策。

结论和实际意义

关联度衡量指标应在特定的研究设计背景下进行解读。在从临床研究中得出结论时,应考虑研究设计和特定的关联度衡量指标。临床医生在应用文献指导实践时,应注意特定研究设计中报告的关联度衡量指标,以及作者是否在其选择的研究设计背景下正确解释了关联度衡量指标。

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