GRADE指南:Ⅴ.证据质量评价——发表偏倚

被引：128

作者：

Gordon H.Guyatt

Andrew D.Oxman

Victor Montori

Gunn Vist

Regina Kunz

Jan Brozek

Pablo Alonso-Coello

Ben Djulbegovic

David Atkins

Yngve Falck-Ytter

John W.Williams Jr.

Joerg Meerpohl

Susan L.Norris

Elie A.Akl

Holger J.Schünemann

代表GRADE工作组

李幼平

王莉

钟大可

蒋兰慧

机构：

来源：

中国循证医学杂志 | 2011年 / 11卷 / 12期

关键词：

GRADE; 证据质量; 发表偏倚; 漏斗图; 利益冲突; 制药业;

D O I：

暂无

中图分类号：

R-03 [];

学科分类号：

摘要：

GRADE方法中,随机试验起评即为高质量证据,观察性研究起评即为低质量证据;但若证据本身存在高发表偏倚风险,则两者证据质量级别都应降低。即使最佳证据汇总表纳入的各项研究仅有低发表偏倚风险,发表偏倚仍会极大高估效应值。当可得证据来自小样本研究、且多数由厂商资助时,作者应怀疑存在发表偏倚。若干基于检验数据类型的方法可用于评价发表偏倚,其中最常用的为漏斗图,但这些方法都有较大局限。发表偏倚可能较常见,必须特别关注早期结果、对样本量与事件数都很小的早期试验结果尤需小心。

引用

页码：1430 / 1434

页数：5

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