临床实践指南制订方法——证据向推荐意见转化

Methodology for clinical practice guidelines--evidence to recommendation

决策的制订过程应清晰而透明,以确保所有的重要因素得到考虑。证据仅是推荐意见制定的决定因素之一,除此之外干预风险、经济成本、卫生服务水平或能力、患者意愿等均是考虑因素。目前尚无一致的方法学,但众多手册提供了可参考的工具,指南制订者可以根据特定指南的实际情况,有选择性的参考引用。

Much more than evidence must be considered when crafting practice recommendations.The evidence-based conclusion and our confidence in the ability of the evidence to support practice recommendations form the foundation.The side effects,risks,cost effectiveness,resource implications,values and preferences and health service delivery issues have been considered in formulating the recommendations.At present,there is no perfect and uniform method to guide the formulation of recommendations.Developers of evidence-based clinical practice guidelines can learn from their experience,combine with their own characteristics of guidelines such as specific target population and specific clinical situations,establish a rational method of recommendations formation.