公共卫生决策证据质量分级方法问题的定性系统评价

Methodological issues in grading the quality of evidence for public health decision-making:a qualitative systematic review

目的 系统评价公共卫生决策证据质量分级方法相关研究问题。方法 计算机检索PubMed、Web of Science、CNKI、WanFang Data、CBM和VIP数据库,搜集公共卫生决策证据质量分级方法应用相关研究,检索时限均为建库至2022年12月。根据SPIDER模型构建问题,采用CASP清单对纳入文献进行质量评价,利用主题综合法对公共卫生决策证据质量分级方法的应用问题进行三级诠释分析,建立问题条目池。结果 共纳入14篇文献,涵盖7个国家。GRADE是常用的证据质量分级方法。CASP评价结果显示高质量研究8篇,中等质量研究4篇,低质量研究2篇。主题综合法归纳出7类13个问题条目。结论 现有的公共卫生决策证据质量分级方法存在证据来源多样、复杂干预研究的证据等级被低估等问题。

Objective To systematically review the research issues related to evidence quality grading methods for public health decision making.Methods PubMed,Web of Science,CNKI,WanFang Data,CBM and VIP databases were electronically searched to collect studies related to the application of evidence quality grading methods for public health decision making from inception to December 2022.The questions were constructed according to the SPIDER model.The quality of the included literature was evaluated by using the CASP checklist,and a three-level interpretation analysis of the questions on the application of quality rating methods for public health decision making was conducted using the thematic synthesis method to establish a pool of question entries.Results A total of 14 papers were included,covering seven countries.GRADE was the commonly used method for grading the quality of evidence.CASP evaluation results showed eight high quality studies,four medium quality studies and two low quality studies.The thematic synthesis method summarized 13 question entries in 7 categories.Conclusion The existing methodology for grading the quality of evidence for public health decision making suffers from the diversity of evidence sources and the underestimation of the level of evidence from complex intervention studies.