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Methodology Chin J Evid-based Med 2014, 14(11): 1402-1406 GRADE在诊断准确性试验系统评价中应用的 原理、方法、挑战及发展趋势 1,2,3# 1,2,3# 4 5 1,2,3 1,2,3 陈耀龙   姚  亮   杜  亮  曾宪涛  韦  当   王  琪   1,2,3 1,2,3* 王小琴   杨克虎 1. 甘肃省循证医学与临床转化重点实验室（兰州 730000 ）；2. 兰州大学循证医学中心，兰州大学基础医学院（兰州 730000 ）； 3. 中国GRADE 中心，兰州大学（兰州 730000 ）；4. 四川大学华西医院中国循证医学中心（成都 610041 ）； 5. 武汉大学中南医院循证与转化医学中心（武汉 430071 ） 摘要 诊断性试验的系统评价按基于原始研究的类型可分为两类：一类是基于诊断性随机对照试验的系统评 价，其GRADE 分级与干预性系统评价的方法类似；另外一类是基于诊断准确性试验的系统评价，其GRADE 分级 原理和方法是本文论述的重点。本文主要从理论分析的角度阐述了GRADE 在诊断准确性试验系统评价中应用的 原理、方法以及挑战。 关键词 GRADE ；证据分级；系统评价；诊断性试验 Rationales, Methods, Challenges and Development Tendency of Using GRADE in Systematic Reviews of Diagnostic Accuracy Tests 1,2,3# 1,2,3# 4 5 1,2,3 1,2,3 CHEN Yao-long , YAO Liang , DU Liang , ZENG Xian-tao , WEI Dang , WANG Qi , WANG Xiao-qin1,2,3, YANG Ke-hu1,2,3* 1. Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; 2. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; 3. Chinese GRADE Center, Lanzhou University, Lanzhou 730000, China; 4. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China; 5. Center for Evidence-based Medicine and Translational Research, Zhongnan Hospital, Wuhan University, Wuhan 430071, China Abstract Depending on different designs of original studies, systematic reviews of diagnostic studies could be cat- egorized into two kinds: one is based on diagnostic randomized controlled trials, of which the GRADE rating approach is similar to that of interventional systematic reviews; and the other is based on diagnostic accuracy tests, of which the GRADE rating approach is introduced in this article. This a