Department of Internal Medicine, Division of Allergy, Rush University Medical Center, Chicago, Ill.
Dartmouth Geisel School of Medicine, Hanover, NH.
J Allergy Clin Immunol Pract. 2024 Oct;12(10):2636-2643. doi: 10.1016/j.jaip.2024.03.008. Epub 2024 Mar 11.
The practice of medicine in recent years has emphasized the use of evidence-based clinical guidelines to help inform treatment decisions. Since its development in 2004, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach has offered a systematic process for reviewing and summarizing the certainty of evidence found in the medical literature regarding various treatment options. To develop truly patient-centered care guidelines, this appraisal of the certainty of evidence must be combined with an understanding of the balance between benefits and harms, patient preferences, equity, feasibility, cost-effectiveness, and policy implications. This review examines each of these domains in detail, exploring the process and benefits of developing relevant, patient-focused guidelines directly applicable to the practice of modern medicine.
近年来，医学实践强调使用基于证据的临床指南来帮助制定治疗决策。自 2004 年开发以来，GRADE（推荐评估、制定与评价）方法为系统地审查和总结医学文献中关于各种治疗选择的证据确定性提供了一种方法。为了制定真正以患者为中心的护理指南，必须将对证据确定性的评估与对收益与危害之间的平衡、患者偏好、公平性、可行性、成本效益和政策影响的理解相结合。本综述详细探讨了这些领域中的每一个领域，探索了制定与现代医学实践直接相关的、以患者为中心的指南的过程和好处。
