真实世界研究:弥合临床实践指南与临床决策之间的距离

Real World Research:Bridging the Gap Between Clinical Practice Guidelines and Clinical Decision Making

临床实践指南是制订临床决策的重要依据,但仍存在诸多因素导致医生无法遵循指南,其中一个重要因素为指南的外部有效性受限,最终使得指南无法为临床决策的制订提供足够依据,此为指南与临床决策之间的距离。真实世界研究可增强指南的外部有效性,为临床决策的制订提供依据,为指南提供本土化证据、成本效益及其他方面相关证据,同时可监测指南的实施,弥补传统指南的证据不足,有助于弥合指南与临床决策之间的距离。在指南制订过程中,可考虑纳入高质量的真实世界研究和真实世界证据,以促进指南优化,助力指南质量提升。

Clinical practice guidelines are an important basis for clinical decision⁃making,but there are still many factors that prevent physicians from following the guidelines.One of the problems,the limited external validity of the guidelines,ultimately prevents the guidelines from providing an adequate basis for clinical deci⁃sion⁃making,thus forming the gap between the guidelines and clinical decisions.Real⁃world research can enhance the external validity of the guidelines,provide a basis for clinical decision⁃making,and offer localized evidence for the guidelines,evidence of cost⁃effectiveness and other evidence for the guidelines.It can also monitor the im⁃plementation of the guidelines and help to make up for the lack of evidence in the formulation of traditional guide⁃lines.Therefore,high⁃quality real⁃world studies and real⁃world evidence may be considered in the guideline de⁃velopment process to facilitate guideline optimization and serve as an aid to guideline quality improvement.