Endres David, Gowik Julia, Tasar Andrea
Ressort Versorgung & Leitlinien, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Siegburger Str. 237, 50679, Köln, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025 Jan;68(1):45-52. doi: 10.1007/s00103-024-03993-4. Epub 2024 Dec 12.
The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Ministry of Health to provide support for the further development of the S2k guideline on first-trimester abortion into an S3 guideline. To this end, the responsible guideline group formulated research questions that were answered in IQWiG evidence reports. One of the questions to be addressed was the evidence regarding the psychological consequences of an abortion in the first trimester compared to no abortion in the first trimester in pregnant women who wish to have an abortion. A systematic search identified one relevant prospective comparative cohort study that reported results on the outcomes of clinically diagnosed depression and clinically diagnosed anxiety disorders. The evidence was evaluated in accordance with the methodological requirements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, as specified by the IQWiG methods. No significant differences were observed between the study groups with regard to the outcomes mentioned. The certainty of the evidence was rated as very low and downgraded due to study limitations and imprecision of the effects. Prospective comparative cohort studies that approach the research question under investigation should, inter alia, have adequate control for relevant confounders, a sufficient number of participants, and a carefully planned collection of data on relevant outcomes.
德国医疗质量与效率研究所（IQWiG）受联邦卫生部委托，为将关于早期妊娠流产的S2k指南进一步完善为S3指南提供支持。为此，负责的指南制定小组提出了研究问题，并在IQWiG证据报告中得到解答。其中一个需要解决的问题是，对于希望流产的孕妇，早期妊娠流产与不流产相比，心理后果方面的证据情况。一项系统检索确定了一项相关的前瞻性比较队列研究，该研究报告了临床诊断的抑郁症和临床诊断的焦虑症结局的结果。根据IQWiG方法中规定的推荐分级评估、制定与评价（GRADE）工作组的方法学要求，对证据进行了评估。在上述结局方面，各研究组之间未观察到显著差异。由于研究局限性和效应的不精确性，证据的确定性被评为极低并进行了降级。针对所研究的问题开展前瞻性比较队列研究时，除其他方面外，应充分控制相关混杂因素、有足够数量的参与者，并精心规划收集有关结局的数据。
