5.循证治疗是.ppt

治疗性研究证据的评价与应用;主要内容;重要性;重要性;重要性;重要性;例1：;实际上;例2;随机对照临床试验得到了未曾预料的结果（ED Stein AE,et al.J Am Coll Cardiol,1991,18:14）：;提示说明;主要内容;治疗性研究证据的分级;主要内容;Case;;question;;;;评价证据（ctitical appraisal）的基本内容;;;1、Was the assignment of patients to treatment randomized?;;本研究实际情况：;2、Was the randomization concealed?;;3、Were the groups similar at the start of the trial?;本研究实际情况：;4、Was follow-up of patients sufficiently long and complete?;;;本研究实际情况：;5、were all patients analyzed in the groups to which they were?;;冠心病手术与药物治疗情况比较;A.效力分析（efficacy analysis）;;冠心病手术与药物治疗效力分析;B.实际治疗分析（treatment received analysis）或解释试验（Expianatory trials）分析;冠心病手术与药物治疗实际治疗分析;;C.意愿治疗???析（intension-to-treat analysis,ITT）;;冠心病手术与药物治疗实际治疗分析;;;冠心病手术与药物治疗三种治疗分析方法;;本研究实际情况：;6、Were patients, clinicians, and study personnel kept blind to treatment?;;本研究实际情况：;7、Were groups treated equally, apart from the experimental therapy?;本研究实际情况：;;1、What is the magnitude of the treatment effect?;;;;;;2、How precise is this estimate of the treatment effect？;;;1、is our patient so different from those in the study that its result cannot apply?;本研究结果;;;4、What are our patient’s values and expectations for both the outcome we are trying to prevent and the treatment we are offering?;;;;