肿瘤中医诊疗指南临床的应用评价的研究.docVIP

肿瘤中医诊疗指南临床的应用评价的研究 　　[摘要] ?u价《肿瘤中医诊疗指南》的适用性和临床应用情况。评价方法包括适用性评价和应用性评价。适用性评价采用调查问卷方法，评价《指南》熟悉和使用情况、质量水平、临床适用情况等；应用性评价采用前瞻性病例调查分析方法，评价《指南》临床应用符合度和应用效果（包括疗效、安全性、经济性）。采用统计学基本描述、构建不同比较组进行交叉或分层统计学检验、多因素分析以及混杂因素处理等多种分析方法。适用性综合性评价结果显示，《指南》内容完全适用和基本适用者为63.03%，不适用者4.24%；应用性综合评价结果显示，《指南》“总体疗效与技术水平”、“满意度”、“在临床实践中的适用性”较好的累计统计分别为85.46%，80.43%，69.40%。该研究表明基地单位医师对《肿瘤中医诊疗指南》的认知度较高，低年资医师是主要使用群体，临床指南总体临床适用、临床应用符合度较好，但《指南》的诊疗方案的质量和适应性等尚需改进。指南在支持证据、方法学规范及临床使用性上有所欠缺，应尽快通过修订进一步提高质量。 　　[关键词] 肿瘤； 中医临床诊疗指南； 应用评价 　　Clinical application evaluation of Guidelines for Diagnosis and 　　Treatment of Cancer in Traditional Chinese Medicine 　　SHI Nannan， LIU Mengyu， LIU Yuqi， WANG Yuexi， WANG Liying， YUWEN Ya， ZHAO Xueyao， WEI Dongfeng， 　　KOU Shuang， HAN Xuejie*， WANG Yanping* 　　（Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences， Beijing 100700， China ） 　　[Abstract] This study aims to evaluate the adaptability and applicability of Guidelines for the Diagnosis and Treatment of Cancer in Traditional Chinese Medicine. The assessment methods included adaptability assessment and applicability assessment. The adaptability assessment was based on the questionnaire survey to evaluate the familiarity， utilization， quality， and clinical application of the Guidelines； applicability assessment was based on the prospective observation of 853 clinical cases to investigate the applicability and effect of the Guidelines， including effectiveness， economy and safety. Statistical analysis for basic description， construction of different comparison groups for cross or hierarchical statistical test， multifactor analysis， and confounding factors were used in the study. Adaptability assessment results showed that 63.03% of TCM doctors considered guidelines as good or very good applicability and 4.24% of TCM doctors considered guidelines with very poor applicability in clinical practice. For the applicability evaluation， TCM doctors considered that the overall efficacy and tec