循证评价与遴选中国东中西部乡院基本药物系列之二:评价标准、方法与流程研究

Evidence-Based Evaluation and Selection of Essential Medicine for Pilot Township Health Centers Located in Eastern,Central and Western China,Part Ⅱ: Study on Evaluation Standards,Methods and Processes

目的制定满足我国8个示范乡院需求的循证评价与遴选基本药物的标准、方法和流程。方法描述性分析比较WHO基本药物评价与遴选和GRADE证据质量与推荐强度的标准、方法、流程的异同和利弊,结合本系列前期研究结果优化组合并改进我国示范乡院基本药物的循证评价与遴选标准、方法及流程。用GRADEpro ler等软件评价证据质量。结果①初步制定出本土化的乡院基本药物循证评价与遴选标准、方法、流程,并确定评价工具。②初步确立了标准化、系统化、透明化疾病名、药品名、指南与检索等。结论①本研究初步制定出评价与遴选我国示范乡院基本药物时比较有效性、安全性、成本–效果及适用性的最佳证据检索、评价与推荐标准、方法和流程;②根据"有证查证用证、无证创证用证"原则,对乡院循证评价与遴选基本药物的标准、方法与流程的本土化、规范化和透明化作了有益探索。

Objective To establish standards, methods and processes for evidence-based evaluation and selection of essential medicine that meet the needs of the 8 pilot township health centers in China. Methods A descriptive analysis was conducted to compare the similarities/differences and the advantages/disadvantages of the standards, methods and processes between the World Health Organization （WHO） essential medicines evaluation and selection, and the GRADE evidence quality and recommend intensity. In combination with the former outcomes of this series of study, the standards, methods and processes of evidence-based evaluation and selection of essential medicines in the domestic pilot township health centers were optimized, restructured and improved. Softwares such as GRADEprofiler were used to assess the qual- ity of evidence. Results a） Localized standards, methods and processes for evidence-based evaluation and selection of es- sential medicine were established, and the evaluation tool was ascertained; and b） Disease and drug names, guidelines and searching processes for evaluation and selection of essential medicine were developed with standardized, systematic and transparent approaches. Conclusion a） Standards, methods and processes for searching, evaluating and recommending the best evidence are preliminarily established, through comparative analysis on the effectiveness, safety, cost-effectiveness and applicability of the candidate medicines for diagnosing, treating and preventing diseases in township health centers in China; b） Following the principle of ＂utilizing the best existing evidences and developing the urgently-needed but lacking evidence＂, a good exploration was done for the localization, standardization and transparency of the standards, methods and processes of evidence-based evaluation and selection of essential medicine for pilot township health centers.