公共卫生决策证据质量的Meta流行病学研究  

The evidence quality of public health decision-making:A meta-epidemiological study

作　　者：黄家艺 邓欣欣 王汉彬 胡晓晔 梁翠 崔璐 杨克虎[1,2,3,4] 李秀霞 HUANG Jia-yi;DENG Xin-xin;WANG Han-bin;HU Xiao-ye;LIANG Cui;CUI Lu;YANG Ke-hu;LI Xiu-xia(Health Technology Assessment Center/Evidence Based Social Science Research Center,School of Public Health,Lanzhou University,Lanzhou Gansu 730000,China;Evidence Based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou Gansu 730000,China;Key Laboratory of Evidence Based Medicine of Gansu Province,Lanzhou Gansu 730000,China;Research Center for Medical Device Regulatory Science,Lanzhou University,Lanzhou Gansu 730000,China)

机构地区：[1]兰州大学卫生技术评估中心/兰州大学循证社会科学研究中心、兰州大学公共卫生学院,甘肃兰州730000 [2]兰州大学循证医学中心、兰州大学基础医学院,甘肃兰州730000 [3]甘肃省循证医学重点实验室,甘肃兰州730000 [4]兰州大学医疗器械监管研究中心,甘肃兰州730000

出　　处：《中国卫生政策研究》2024年第10期76-81,共6页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(72074103)。

摘　　要：目的:比较公共卫生决策证据质量评价体系(PHE-Grading)与推荐分级的评价、制定与评估体系(GRADE)在评价公共卫生决策证据质量方面的差异性。方法:计算机检索Cochrane Library数据库,获取建库起至2024年2月27日发表的有关“Public health”主题的系统评价。采用EndNote 20软件进行文献筛选,Excel 2021和SPSS 22.0软件进行数据整理和分析,使用RevMan 5.4.1软件绘制森林图。结果:最终纳入61篇系统评价进行证据质量评价。GRADE和PHE-Grading证据分级结果的森林图显示,证据等级为高[OR:2.39,95%CI(1.21,4.75)]、中[OR:0.40,95%CI(0.31,0.52)]、低[OR:0.37,95%CI(0.29,0.46)]和极低[OR:85.11,95%CI(34.80,208.11)],证据质量分级结果的差异有统计学意义。结论:与GRADE相比,PHE-Grading对公共卫生决策证据确信度的把握可能更为精准,目前公共卫生决策证据质量仍集中在中低水平,仍需加强高质量研究以支持科学决策。Objective:To compare the difference between the Evidence Quality Grading System for Public Health Decision-making(PHE-Grading)and the Grading of Recommendations Assessment,Development and Evaluation(GRADE)System in evaluating the quality of evidence for public health decision-making.Methods:Systematic reviews about topic“Public health”were electronically searched in the Cochrane Library database from inception to February 27,2024.EndNote 20 software was used for literature screening,Excel 2021 and SPSS 22.0 software were used for data collation and analysis,and the forest plot was drawn by RevMan 5.4.1 software.Results:A total of 61 systematic reviews were finally included for evidence quality evaluation.The forest plot of GRADE and PHE-Grading evidence grading results showed that high grade[OR:2.39,95%CI(1.21 to 4.75)],moderate grade[OR:0.40,95%CI(0.31 to 0.52)],low grade[OR:0.37,95%CI(0.29 to 0.46)],and extremely low grade[OR:85.11,95%CI(34.80 to 208.11)],and the differences in evidence quality grading results between the two systems were statistically significant.Conclusions:Compared with GRADE,PHE-Grading may be more accurate in grasping the certainty of public health decision-making evidence.Currently,the quality of public health decision-making evidence is still concentrated in low and middle level,and high-quality research still needs to be strengthened to support scientific decision-making.

关 键 词：公共卫生 决策 证据质量 GRADE方法 PHE-Grading 

分 类 号：R197[医药卫生—卫生事业管理]