EBM简报范例三-秀传医疗社团法人秀传纪念医院.ppt

the results were similar from study to study (look for tests of heterogeneity) 舉例：The results of the meta-analysis showed it had significant difference between acupuncture and sham treatments. Analysis of the acupuncture and sham treatments (measured with simply scoring) favored the regimen (RR = 2.49, 95 % CI = 1.06–5.84). There were significant differences between these two groups (p = 0.04), while no heterogeneity existed between these two RCTs (I2 = 39.9 %). the reasons for any variations in results are discussed The acupuncture points used in these 18 RCTs were different; this may be because of the specificity of acupuncture trials. The number of treatment sessions also varied from study to study, although for most of the RCTs conducted in China, about 30 sessions were held. This variable likely has an effect on treatment effectiveness and furthermore could be the reason for unsatisfactory results in studies involving fewer treatment sessions (such as those English studies). 由上述各細項檢視，包括各研究詳細的結果、研究之間的同質性以及可能影響分析結果的各研究變異性，作者均有提及，因此併合研究分析是合理的。 6. How are the results presented and what is the main result? Consider: how the results are expressed (e.g. odds ratio, relative risk, etc.) 由上表中可知研究結果以relative risk作為呈現 以此圖表為例，比較各研究針灸與一般西醫治療的差異性，以RR (relative risk)為統計指標，並配合95％CI (信賴區間)評估。各單獨研究，當RR在1的左右任何一端，且CI線不超越1的另一頭，視為有顯著差異。此外，在不同分組群裡，分別做出混合權重的統合分析，並以p-value評估顯著差異性，最後再做整體的統合分析，最終顯示RR = 1.18, 95 % CI = 1.02–1.37, p = 0.03，表示針灸治療組與西醫一般醫療組相比是有顯著差異性的。 how large this size of result is and how meaningful it is The 18 RCTs included 1,086 patients: 580 patients in either a traditional acupuncture or electrical acupuncture group and 506 patients in the control group. Most studies had relatively small sample sizes. Only two had more than 100 samples. Mean age among study patients was 46 years (ranging from 18 to 72) and 49 % of the patients were males. The causes of the tinnitus reported in these studies were largely unknown. The duration of