运用德尔菲法构建公共卫生决策证据质量分级系统  

Using the Delphi method to construct a system for grading the quality of evidence for public health decision-making

作　　者：商雪 邓欣欣 郭康乐 周丽营 杨克虎[1,2,3] 李秀霞 SHANG Xue;DENG Xin-xin;GUO Kang-le;ZHOU Li-ying;YANG Ke-hu;LI Xiu-xia(School of Public Health,Lanzhou University,Lanzhou Gansu 730000,China;Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province,Lanzhou Gansu 730000,China;School of Basic Medical Sciences,Lanzhou University,Lanzhou Gansu 730000,China;Gansu Provincial Hospital,Lanzhou Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院,甘肃兰州730000 [2]甘肃省循证医学与临床转化重点实验室,甘肃兰州730000 [3]兰州大学基础医学院,甘肃兰州730000 [4]甘肃省人民医院,甘肃兰州730000

出　　处：《中国卫生政策研究》2023年第10期71-78,共8页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(72074103)。

摘　　要：目的:构建适用于公共卫生决策领域的证据质量分级方法。方法:基于德尔菲调查法对24名专家进行2轮函询,形成证据评价的条目内容、评分细则及综合评价方法的共识。结果:2轮函询后专家意见基本一致,问卷回收率均高于80%,专家积极系数较好;权威系数均高于0.85;Kendall协调系数分别为0.227和0.494,显示具有统计学意义(P<0.05)。整合专家意见,最终构建15个一级条目、55个二级条目,综合各部分条目评价结果(最高计15分),最终转化为高(>11)、中((8-11])、低((4-8])、极低(≤4)4个级别的证据强度。结论:基于德尔菲调查法初步建立了公共卫生决策证据质量分级系统,具有较好的适用性和可行性,但其系统性能和可推广性有待进一步验证。Objective:To construct a grading method for evidence quality applicable to the field of public health decision-making.Methods:Based on Delphi survey method,24 experts were consulted for two rounds of correspondence to form a consensus on the contents of evidence evaluation items,scoring rules and comprehensive evaluation methods.Results:With the recovery rate being higher than 80%in the two rounds of correspondence interview,the experts opinions were seen basically the same,and their positive coefficient was good.The authority coefficient was higher than 0.85.Kendall coordination coefficients were 0.227 and 0.494,respectively,showing statistical significance(P<0.05).According to the experts opinion,15 first-level items,55 second-level items and 25 third-level items were finally constructed,and the evidence strength was finally translated into four levels based on the evaluation results of each part of items(up to 15 points):high(>11),moderate((8-11]),low((4-8])and very low(≤4).Conclusions:Based on Delphi survey method,the grading system for evidence quality in public health decision-making is initially established,which has good applicability and feasibility,but its system performance and extensibility need to be further verified.

关 键 词：GRADE方法 证据分级 公共卫生 德尔菲法 

分 类 号：R197[医药卫生—卫生事业管理]