RCT文獻(xiàn)質(zhì)量評(píng)價(jià)50086PPT學(xué)習(xí)教案

1、會(huì)計(jì)學(xué)1 RCT文獻(xiàn)質(zhì)量評(píng)價(jià)文獻(xiàn)質(zhì)量評(píng)價(jià)50086 嚴(yán)格文獻(xiàn)評(píng)價(jià) 證據(jù)的質(zhì)量 表表 循循征征醫(yī)醫(yī)學(xué)學(xué)證證據(jù)據(jù)分分級(jí)級(jí)水水平平及及依依據(jù)據(jù) 推推薦薦分分級(jí)級(jí) 治治療療、預(yù)預(yù)防防、病病因因的的證證據(jù)據(jù) A A 高高質(zhì)質(zhì)量量 R RC CT Ts s 的的系系統(tǒng)統(tǒng)綜綜述述 B B 單單個(gè)個(gè)大大樣樣本本 R RC CT T C C 未未使使用用 R RC CT T 但但設(shè)設(shè)計(jì)計(jì)很很好好的的隊(duì)隊(duì)列列研研究究、病病例例- -對(duì)對(duì)照照研研 究究或或無(wú)無(wú)對(duì)對(duì)照照的的系系列列病病例例觀觀察察 D D 專專家家個(gè)個(gè)人人意意見(jiàn)見(jiàn)、個(gè)個(gè)例例報(bào)報(bào)告告 第1頁(yè)/共33頁(yè) 第2頁(yè)/共33頁(yè) 第3頁(yè)/共33頁(yè) 第4頁(yè)/共33

2、頁(yè) nOther bias（其它影響真實(shí)性因素： 無(wú)其它偏倚） 第5頁(yè)/共33頁(yè) 第6頁(yè)/共33頁(yè) 第7頁(yè)/共33頁(yè) 第8頁(yè)/共33頁(yè) 第9頁(yè)/共33頁(yè) 第10頁(yè)/共33頁(yè) 第11頁(yè)/共33頁(yè) 第12頁(yè)/共33頁(yè) 第13頁(yè)/共33頁(yè) 第14頁(yè)/共33頁(yè) 隱蔽分組（分配隱藏）和盲法的概念、實(shí)施與報(bào)告 吳泰相 劉關(guān)鍵中國(guó)循證醫(yī)學(xué)雜志, 2007, 7(3): 222225. 第15頁(yè)/共33頁(yè) 第16頁(yè)/共33頁(yè) 第17頁(yè)/共33頁(yè) 第18頁(yè)/共33頁(yè) 第19頁(yè)/共33頁(yè) 第20頁(yè)/共33頁(yè) 第21頁(yè)/共33頁(yè) n發(fā)現(xiàn)的問(wèn)題是否導(dǎo)致偏倚，理由或發(fā)現(xiàn)的問(wèn)題是否導(dǎo)致偏倚，理由或 依據(jù)不足依據(jù)不足 第2

3、2頁(yè)/共33頁(yè) 第23頁(yè)/共33頁(yè) 第24頁(yè)/共33頁(yè) 第25頁(yè)/共33頁(yè) 第26頁(yè)/共33頁(yè) EntryEntryJudgementJudgementDescriptionDescription Adequate sequence generation? Yes.Quote: “patients were randomly allocated.” Comment: Probably done, since earlier reports from the same investigators clearly describe use of random sequences (Cartwrig

4、ht 1980). Allocation concealment? No.Quote: “.using a table of random numbers.” Comment: Probably not done. Blinding? (Patient- reported outcomes) Yes.Quote: “double blind, double dummy”; “High and low dose tablets or capsules were indistinguishable in all aspects of their outward appearance. For ea

5、ch drug an identically matched placebo was available (the success of blinding was evaluated by examining the drugs before distribution).” Comment: Probably done. 第27頁(yè)/共33頁(yè) Blinding? (Mortality)Yes.Obtained from medical records; review authors do not believe this will introduce bias. Incomplete outco

6、me data addressed? (Short-term outcomes (2-6 wks) No.4 weeks: 17/110 missing from intervention group (9 due to lack of efficacy); 7/113 missing from control group (2 due to lack of efficacy). Incomplete outcome data addressed? (Longer-term outcomes (6 wks) No.12 weeks: 31/110 missing from intervention group; 18/113 missing from control group. Reasons differ across groups. Free of selective reporting? No.Three rating scales for cognition listed in Methods, but only one reported. Free of other bias?NoTrial stopped