目的 在循證臨床實踐中，醫(yī)務(wù)人員需要正確理解臨床研究中療效指標(biāo)的意義。本研究旨在評價相同臨床研究結(jié)果的不同表述方式對研究生選擇和推薦治療措施的影響，從而了解已經(jīng)過“臨床科研設(shè)計”課程學(xué)習(xí)的研究生對療效指標(biāo)的理解。
方法 將同一系統(tǒng)評價的結(jié)果采用4種療效指標(biāo)表述，設(shè)計問卷對參與“臨床科研設(shè)計”課程考試的研究生進行調(diào)查。
結(jié)果 共發(fā)出和收回問卷342份，排除4份未回答所有結(jié)果的問卷，有效問卷338份。結(jié)果顯示，研究生選擇絕對危險度降低率（ARR）與需要治療的患者數(shù)（NNT）、相對危險度降低率（RRR）與NNT、試驗組和對照組未發(fā)生事件率的差異（EFP）與NNT間的分值差異和治療推薦級別差異均有統(tǒng)計學(xué)意義（P lt;0.01）；ARR、RRR與EFP間差異無統(tǒng)計學(xué)意義。但279名研究生選擇4種療效指標(biāo)得分的極差大于4分。
結(jié)論 經(jīng)過“臨床科研設(shè)計”課程學(xué)習(xí)的研究生在理解療效指標(biāo)意義上仍然存在問題。因此，課堂教學(xué)應(yīng)加強對臨床研究結(jié)果的不同表述方式和相關(guān)指標(biāo)臨床意義的講解。
引用本文： 李靜,艾昌林,張鳴明,袁文明,徐琳,張小利,劉關(guān)鍵,李幼平. 研究結(jié)果的表述方式是否會影響治療決策. 中國循證醫(yī)學(xué)雜志, 2007, 07(5): 344-347. doi: 復(fù)制
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- 1. Nexoe J, Gyrd-Hansen D, Kragstrup J, et al. Danish GPs’ perception of disease risk and benefit of prevention. Fam Pract, 2002, 19(1): 3-6.
- 2. Fahey T, Griffiths S, Peters TJ. Evidence based purchasing: understanding results of clinical trials and systematic reviews. BMJ, 1995, 311(7012): 1056-1059; discussion 1059-1060.
- 3. Oldridge NB, Guyatt GH, Fischer ME, et al. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA, 1988, 260(7): 945-950.
- 4. Barratt A, Wyer PC, Hatala R, et al. Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat. CMAJ, 2004, 171(4): 353-358.
- 5. Cranney M, Walley T. Same information, different decisions: the influence of evidence on the management of hypertension in the elderly. Br J Gen Pract, 1996, 46(412): 661-663.
- 6. Nexoe J, Oltarzewska AM, Sawicka-Powierza J, et al. Perception of risk information. Similarities and differences between Danish and Polish general practitioners. Scand J Prim Health Care, 2002, 20(3): 183-187.