循证医学 5系统综述与meta分析学习课件.pdf

系统综述与系统综述与metameta分析分析

流行病学与卫生统计学学科

余运贤

DepartmentofEpidemiologyBio-Statistics

许多问题困扰着各位许多问题困扰着各位！

Hyperglycemiaiscommoninacutelyillpatients,includingthose

treatedinintensivecareunits(ICUs).

Theoccurrenceofhyperglycemia,inparticularsevere

hyperglycemia,isassociatedwithincreasedmorbidityand

mortalityinavarietyofgroupsofpatients

TrialsTrialsexaminingexaminingthetheeffectseffectsofoftightertighterglucoseglucosecontrolcontrolhavehavehadhad

conflictingresults

Systematicreviewsandmeta-analyseshavealsoledtodiffering

conclusionsconclusions.

Nevertheless,manyprofessionalorganizationsrecommendtight

glucosecontrolforpatientstreatedinICUs.

BarriersBarrierstotowidespreadwidespreadadoptionadoptionofoftighttightglucoseglucosecontrolcontrolincludeinclude

theincreasedriskofseverehypoglycemia,thedifficultyin

achievingnormoglycemiaincriticallyillpatients,andthe

increasedresourcesthatwouldberequired.

ICU病人的血糖应该控制什么样的范围？

DepartmentofEpidemiologyBio-Statistics

多中心的多中心的RCTRCT

NICENICE-SUGARSUGARStudyStudyInvestigatorsInvestigators.NNEnglEnglJJMedMed2009;360360:1283-9797.

DepartmentofEpidemiologyBio-Statistics

Griesdale,etal.

CMAJ.2009Apr

14;180((8)):821-7.

DepartmentofEpidemiologyBio-Statistics

MMeta分析的定义分析的定义

采用统计学方法采用统计学方法，将多个独立的将多个独立的、针对同针对同

一个临床问题，可以合成的临床研究综合

起来进行定量分析。

中文译名：荟萃分析，汇总分析、集成分

析、二次分析、衍生分析等

DepartmentofEpidemiologyBio-Statistics

MMeta分析的目的分析的目的

增加统计学的检验功效

评价研究结果的不评价研究结果的不一致性致性，解决研究中矛盾解决研究中矛盾