知證衛生決策工具之十六——使用研究證據權衡政策的利弊*_《中國循證醫學雜志》

作者：

Andrew D Oxman ¹ , John N Lavis ² , Atle Fretheim ³ , Simon Lewin ⁴

關鍵詞：

DOI：

10.7507/1672-2531.20100441

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本文是為衛生政策及規劃的決策者及其支持者寫的系列文章之一。本文提出使用證據以判斷所選政策和衛生規劃的利弊關系。作出判斷時我們建議考慮以下五個問題：① 進行比較的選擇是什么？② 所比較的選擇最重要的可能結果是什么？③ 對所比較的選擇每一項重要結果而言，其影響的最佳估計是什么？④ 對所估計的影響，決策者及其他相關人員有多大的把握度？⑤ 有無正規的經濟學模型幫助決策？

引用本文： Andrew D Oxman,John N Lavis,Atle Fretheim,Simon Lewin. 知證衛生決策工具之十六——使用研究證據權衡政策的利弊*. 中國循證醫學雜志, 2010, 10(5): 527-533. doi: 10.7507/1672-2531.20100441 復制

1.	Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2.	Chalmers I. If evidence-informed policy works in practice, does it matter if it doesn’t work in theory? Evidence & Policy, 2005, 1: 227-242.
3.	Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ, 2008, 336: 1049-1051.
4.	Oxman AD, Fretheim A, Lavis JN, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 12. Finding and using research evidence about resource use and costs. Health Res Policy Syst, 2009, 7(Suppl 1): S12.
5.	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336: 924-926.
6.	The SUPPORT Collaboration: How SUPPORT Summaries are prepared 2009 [http://www.support-collaboration.org/summaries/ methods.htm].
7.	Lavis JN, Oxman AD, Grimshaw J, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 7. Finding systematic reviews. Health Res Policy Syst, 2009, 7(Suppl 1): S7.
8.	Guyatt G, Oxman A, Kunz R, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and Summary of Findings tables. J Clin Epidemiol, in press.
9.	Oxman AD, Lavis JN, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 10. Taking equity into consideration when assessing the findings of a systematic review. Health Res Policy Syst, 2009, 7(Suppl 1): S10.
10.	Akl E, Oxman A, Herrin J, et al. Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database of Systematic Reviews, in press.
11.	Adily A, Ward J. Evidence based practice in population health: a re gional survey to inform workforce development and organisational change. J Epidemiol Community Health, 2004, 58: 455-460.
12.	Guyatt GH, Oxman AD, Kunz R, et al. What is "quality of evidence" and why is it important to clinicians? BMJ, 2008, 336: 995-998.
13.	Kleijnen J, Gotzsche P, Kunz R, et al. So what’s so special about randomisation. In Non-Random Reflections on Health Care Research: On the 25th Anniversary Of Archie Cochrane’s Effectiveness and Efficiency Edited by: Chalmers I, Maynard A. London: BMJ Publishers; 1997: 93-106.
14.	Kunz R, Oxman AD. The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials. BMJ, 1998, 317: 1185-1190.
15.	Savedoff WD, Levine R, Birdsall N. When will we ever learn? Improving lives through impact evaluation 2006 [http://www.cgdev. org/files/7973_file_WillWeEverLearn.pdf]. Washington DC, Center for Global Development.
16.	Hopewell S, Loudon K, Clarke MJ, et al. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database Syst Rev, 2009, 1: MR000006.
17.	Guyatt GH, Oxman AD, Kunz R, et al. Incorporating considerations of resources use into grading recommendations. BMJ, 2008, 336: 1170-1173.
18.	Friedberg M, Saffran B, Stinson TJ, et al. Evaluation of conflict of interest in economic analyses of new drugs used in oncology. JAMA, 1999, 282: 1453-1457.
19.	Macintyre S, Petticrew M. Good intentions and received wisdom are not enough. J Epidemiol Community Health, 2000, 54: 802-803.
20.	Chalmers I. Invalid health information is potentially lethal. BMJ, 2001, 322: 998.
21.	Gilbert R, Salanti G, Harden M, et al. Infant sleeping position and the sudden infant death syndrome: systematic review of observational studies and historical review of recommendations from 1940 to 2002. Int J Epidemiol, 2005, 34: 874-887.
22.	Oxman AD, Lavis JN, Fretheim A, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 17. Dealing with insufficient research evidence. Health Res Policy Syst, 2009, 7(Suppl 1): S17.
23.	Eddy DM. Comparing benefits and harms: the balance sheet. JAMA, 1990, 263: 2493, 2498, 2501.
24.	Stead LF, Lancaster T. Interventions for preventing tobacco sales to minors. Cochrane Database Syst Rev, 2005, 1: CD001497.
25.	Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy, 2007, 82: 78-94.
26.	Aaserud M, Trommald M, Oxman AD, et al. [Evaluation of reimbursement applications for new drugs]. Tidsskr Nor Laegeforen, 2002, 122: 2619-2623.

1. Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2. Chalmers I. If evidence-informed policy works in practice, does it matter if it doesn’t work in theory? Evidence & Policy, 2005, 1: 227-242.
3. Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ, 2008, 336: 1049-1051.
4. Oxman AD, Fretheim A, Lavis JN, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 12. Finding and using research evidence about resource use and costs. Health Res Policy Syst, 2009, 7(Suppl 1): S12.
5. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336: 924-926.
6. The SUPPORT Collaboration: How SUPPORT Summaries are prepared 2009 [http://www.support-collaboration.org/summaries/ methods.htm].
7. Lavis JN, Oxman AD, Grimshaw J, et al. SUPPORT Tools for evidence- informed health Policymaking (STP). 7. Finding systematic reviews. Health Res Policy Syst, 2009, 7(Suppl 1): S7.
8. Guyatt G, Oxman A, Kunz R, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and Summary of Findings tables. J Clin Epidemiol, in press.
9. Oxman AD, Lavis JN, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). 10. Taking equity into consideration when assessing the findings of a systematic review. Health Res Policy Syst, 2009, 7(Suppl 1): S10.
10. Akl E, Oxman A, Herrin J, et al. Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database of Systematic Reviews, in press.
11. Adily A, Ward J. Evidence based practice in population health: a re gional survey to inform workforce development and organisational change. J Epidemiol Community Health, 2004, 58: 455-460.
12. Guyatt GH, Oxman AD, Kunz R, et al. What is "quality of evidence" and why is it important to clinicians? BMJ, 2008, 336: 995-998.
13. Kleijnen J, Gotzsche P, Kunz R, et al. So what’s so special about randomisation. In Non-Random Reflections on Health Care Research: On the 25th Anniversary Of Archie Cochrane’s Effectiveness and Efficiency Edited by: Chalmers I, Maynard A. London: BMJ Publishers; 1997: 93-106.
14. Kunz R, Oxman AD. The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials. BMJ, 1998, 317: 1185-1190.
15. Savedoff WD, Levine R, Birdsall N. When will we ever learn? Improving lives through impact evaluation 2006 [http://www.cgdev. org/files/7973_file_WillWeEverLearn.pdf]. Washington DC, Center for Global Development.
16. Hopewell S, Loudon K, Clarke MJ, et al. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database Syst Rev, 2009, 1: MR000006.
17. Guyatt GH, Oxman AD, Kunz R, et al. Incorporating considerations of resources use into grading recommendations. BMJ, 2008, 336: 1170-1173.
18. Friedberg M, Saffran B, Stinson TJ, et al. Evaluation of conflict of interest in economic analyses of new drugs used in oncology. JAMA, 1999, 282: 1453-1457.
19. Macintyre S, Petticrew M. Good intentions and received wisdom are not enough. J Epidemiol Community Health, 2000, 54: 802-803.
20. Chalmers I. Invalid health information is potentially lethal. BMJ, 2001, 322: 998.
21. Gilbert R, Salanti G, Harden M, et al. Infant sleeping position and the sudden infant death syndrome: systematic review of observational studies and historical review of recommendations from 1940 to 2002. Int J Epidemiol, 2005, 34: 874-887.
22. Oxman AD, Lavis JN, Fretheim A, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). 17. Dealing with insufficient research evidence. Health Res Policy Syst, 2009, 7(Suppl 1): S17.
23. Eddy DM. Comparing benefits and harms: the balance sheet. JAMA, 1990, 263: 2493, 2498, 2501.
24. Stead LF, Lancaster T. Interventions for preventing tobacco sales to minors. Cochrane Database Syst Rev, 2005, 1: CD001497.
25. Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy, 2007, 82: 78-94.
26. Aaserud M, Trommald M, Oxman AD, et al. [Evaluation of reimbursement applications for new drugs]. Tidsskr Nor Laegeforen, 2002, 122: 2619-2623.

《中國循證醫學雜志》

知證衛生決策工具之十六——使用研究證據權衡政策的利弊*

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《中國循證醫學雜志》

知證衛生決策工具之十六——使用研究證據權衡政策的利弊*

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