面瘫指南课件.pptVIP

AAN Classification of Evidencefor Diagnostic Accuracy, cont. Class II: A randomized controlled clinical trial of the intervention of interest in a representative population with masked or objective outcome assessment that lacks one criteria a?e above or a prospective matched cohort study with masked or objective outcome assessment in a representative population that meets b?e above. Relevant baseline characteristics are presented and substantially equivalent among treatment groups or there is appropriate statistical adjustment for differences. Class III: All other controlled trials (including well-defined natural history controls or patients serving as own controls) in a representative population, where outcome is independently assessed, or independently derived by objective outcome measurement.** AAN Classification of Evidencefor Diagnostic Accuracy, cont. Class IV: Studies not meeting Class I, II or III criteria including consensus or expert opinion. *Note that numbers 1?3 in Class I, item 5 are required for Class II in equivalence trials. If any one of the three is missing, the class is automatically downgraded to Class III. **Objective outcome measurement: an outcome measure that is unlikely to be affected by an observer’s (patient, treating physician, investigator) expectation or bias (e.g., blood tests, administrative outcome data). Clinical Question 1 For patients with new-onset Bell palsy does treatment with steroids improve facial functional recovery? Steroids: Conclusion For patients with new-onset Bell palsy, it is highly likely that steroids are effective in increasing the probability of complete facial functional recovery (number needed to treat 6 to 8, two Class I studies). . Steroids: Recommendation For patients with new-onset Bell palsy, oral steroids should be offered to increase the probability of recovery of facial nerve function (Level A). Clinical Question 2 For patients with new-onset Bell palsy does treatment with antiviral agents