系統評價再評價納入研究的質量評價方法調查_《中國循證醫學雜志》

作者：

袁金秋 ^1,2 ,  劉雅莉 ^1,3 , 楊克虎 ^1,4 , 陳耀龍 ¹ , 楊曼 ^1,4

1. 蘭州大學循證醫學中心，蘭州大學基礎醫學院（蘭州 730000）；2. 香港中文大學公共衛生及基層醫療學院（香港）；3. 蘭州大學中西醫結合研究所（蘭州 730000）；4. 蘭州大學第一臨床醫學院（蘭州 730000）;

關鍵詞：

系統評價再評價系統評價質量評價方法

DOI：

10.7507/1672-2531.20120038

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　對當前發表的系統評價再評價（overviews of reviews，簡稱Overviews）納入研究的質量評價方法進行調查分析，為Overviews制作者提供方法學參考。
方法　計算機檢索Cochrane Library（2010年第1期）、PubMed、EMbase和中國生物醫學文獻數據庫（CBM），檢索時間截至2009年12月，遴選出具代表性的Overviews。然后提取其質量評價標準等相關資料進行分析，并對主要質量評價標準進行討論分析。
結果　共遴選出43個具有代表性的Overviews，其中32個（74.4%）對納入的系統評價進行了方法學質量評估，15個采用OQAQ標準（34.9%）、3個采用AMSTAR標準（7.0%）、2個采用DARE清單（4.6%）、2個采用Assendelft標準（4.6%）、1個采用Effective Public Health Practice Project標準（2.3%）、6個采用自定義標準（14.0%），1個采用綜合標準（2.3%），2個為其他（4.6%）。有10個研究（23.6%）進行了證據質量評價，其中8個研究（18.6%）應用GRADE分級系統進行評價，7個研究（16.3%）同時應用了證據質量評價和GRADE分級評價方法。
結論　現有Overviews對納入研究的質量評價包括方法學質量和證據質量，但大多數現已發表的Overviews文獻的質量評價實施并不完整。同時，現已發表Overviews中采用的方法學質量評價標準眾多，尚無統一標準。鑒于OQAQ標準和AMSTAR標準評價內容全面，實施簡易，其應用相對廣泛，并得到了推薦，建議Overviews作者合理選擇應用。GRADE系統相比其他證據質量分級系統更具系統性和全面性，推薦制作者在研究過程中正確使用，使Overviews研究結果更加完整，便于臨床推廣應用。

引用本文： 袁金秋,劉雅莉,楊克虎,陳耀龍,楊曼. 系統評價再評價納入研究的質量評價方法調查. 中國循證醫學雜志, 2012, 12(2): 238-242. doi: 10.7507/1672-2531.20120038 復制

1.	楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的“系統評價再評價”. 中國循證兒科雜志, 2011, (1): 321-324.
2.	Becker LA, Oxman AD. Chapter 22: Overviews of reviews. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.2 (updated September 2009). The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
3.	Keus F, Gooszen HG, van Laarhoven CJ. Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. An overview of Cochrane Hepato-Biliary Group reviews. Cochrane Database Syst Rev, 2010, (1): CD008318.
4.	Seida JK, Ospina MB, Karkhaneh M, et al. Systematic reviews of psychosocial interventions for autism: an umbrella review. Dev Med Child Neurol, 2009, 51(2): 95-104.
5.	Helfand M, Buckley DI, Freeman M, et al. Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U.S. Preventive Services Task Force. Ann Intern Med, 2009, 151(7): 496-507.
6.	Mikton C, Butchart A. Child maltreatment prevention: A systematic review of reviews. Bull World Health Organ, 2009, 87(5): 353-361.
7.	Peters LW, Kok G, Ten Dam GT, et al. Effective elements of school health promotion across behavioral domains: a systematic review of reviews. BMC Public Health, 2009, 9: 182.
8.	Moe RH, Haavardsholm EA, Christie A, et al. Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: an umbrella review of high-quality systematic reviews. Phys Ther, 2007, 87(12): 1716-1227.
9.	Jamtvedt G, Dahm KT, Christie A, et al. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Phys Ther, 2008, 88(1): 123-136.
10.	Christie A, Jamtvedt G, Dahm KT, et al. Effectiveness of nonpharmacological and nonsurgical interventions for patients with rheumatoid arthritis: an overview of systematic reviews. Phys Ther, 2007, 87(12): 1697-1715.
11.	Bradley JM, Moran FM, Elborn JS. Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: An overview of five Cochrane systematic reviews. Respir Med, 2006, 100(2): 191-201.
12.	Krishnan JA, Segal JB, Streiff MB, et al. Treatment of venous thromboembolism with low-molecular-weight heparin: a synthesis of the evidence published in systematic literature reviews. RespirMed, 2004, 98(5): 376-386.
13.	Smith V, Devane D, Begley CM, et al. A systematic review and quality assessment of systematic reviews of randomised trials of interventions for preventing and treating preterm birth. Eur J Obstet Gynecol Reprod Biol, 2009, 142(1): 3-11.
14.	Main C, Thomas S, Ogilvie D, et al. Population tobacco control interventions and their effects on social inequalities in smoking: placing an equity lens on existing systematic reviews. BMC Public Health, 2008, 8: 178.
15.	Lewin S, Lavis JN, Oxman AD, et al. Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. Lancet, 2008, 372(9642): 928-939.
16.	Franx G, Kroon H, Grimshaw J, et al. Organizational change to transfer knowledge and improve quality and outcomes of care for patients with severe mental illness: a systematic overview of reviews. Can J Psychiatry, 2008, 53(5): 294-305.
17.	Bambra C, Gibson M, Sowden AJ, et al. Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment. Prev Med, 2009, 48(5): 454-461.
18.	Althabe F, Bergel E, Cafferata ML, et al. Strategies for improving the quality of health care in maternal and child health in low- and middle-income countries: an overview of systematic reviews. Paediatr Perinat Epidemiol, 2008, 22Suppl1: 42-60.
19.	Akl EA, Muti P, Schünemann HJ. Anticoagulation in patients with cancer: an overview of reviews. Pol Arch Med Wewn, 2008, 118(4): 183-193.
20.	Prior M, Guerin M, Grimmer-Somers K. The effectiveness of clinical guideline implementation strategies - A synthesis of systematic review findings. J Eval Clin Pract, 2008, 14(5): 888-897.
21.	Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on nonpharmacological conservative treatment for patellofemoral pain syndrome. J Orthop Sports Phys Ther, 2008, 38(9): 529-541.
22.	Clarke M. Systematic review of reviews of risk factors for intracranial aneurysms. Neuroradiology, 2008, 50(8): 653-664.
23.	Taylor NF, Dodd KJ, Shields N, et al. Therapeutic exercise in physiotherapy practice is beneficial: a summary of systematic reviews 2002-2005. Aust J Physiother, 2007, 53(1): 7-16.
24.	Kuukasjärvi P, Malmivaara A, Halinen M, et al. Overview of systematic reviews on invasive treatment of stable coronary artery disease. Int J Technol Assess Health Care, 2006, 22(2): 219-234.
25.	Wensing M, Wollersheim H, Grol R. Organizational interventions to implement improvements in patient care: a structured review of reviews. Implement Sci, 2006, 1: 2.
26.	Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther, 2005, 85(11): 1208-1223.
27.	Smidt N, de Vet HC, Bouter LM, et al. Effectiveness of exercise therapy: a best-evidence summary of systematic reviews. Aust J Physiother, 2005, 51(2): 71-85.
28.	Sohn W, Ismail AI, Tellez M. Efficacy of educational interventions targeting primary care providers'practice behaviors: an overview of published systematic reviews. J Public Health Dent, 2004, 64(3): 164-172.
29.	Glazener CM, Evans JH, Peto RE. Treating nocturnal enuresis in children: review of evidence. J Wound Ostomy Continence Nurs, 2004, 31(4): 223-234.
30.	Linde K, ter Riet G, Hondras M, et al. Systematic reviews of herbal medicines--an annotated bibliography. Forsch Komplementarmed Klass Naturheilkd, 2003, 10 Suppl 1: 17-27.
31.	Grimshaw JM, Shirran L, Thomas R, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care, 2001, 39(8 Suppl 2): II2-45.
32.	Furlan AD, Clarke J, Esmail R, et al. A critical review of reviews on the treatment of chronic low back pain. Spine, 2001, 26(7): E155-162.
33.	Anttila H, Suoranta J, Malmivaara A, et al. Effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy: a focused review. Am J Phys Med Rehabil, 2008, 87(6): 478-501.
34.	Ozbilen M, Adams CE. Systematic overview of Cochrane reviews for anticholinergic effects of antipsychotic drugs . J Clin Psychopharmacol, 2009, 29(2): 141-146.
35.	Cnossen JS, ter Riet G, Mol BW, et al. Are tests for predicting pre-eclampsia good enough to make screening viable? A review of reviews and critical appraisal. Acta Obstet Gynecol Scand, 2009, 88(7): 758-765.
36.	Law J, Plunkett C, Taylor J, et al. Developing policy in the provision of parenting programmes: Integrating a review of reviews with the perspectives of both parents and professionals. Child Care Health Dev, 2009, 35(3): 302-312.
37.	Lemmens V, Oenema A, Knut IK, et al. Effectiveness of smoking cessation interventions among adults: A systematic review of reviews. Eur J Cancer Prev, 2008, 17(6): 535-544.
38.	Nilsen P, Yorkston E. Uncovering evidence on community-based injury prevention: A review of programme effectiveness and factors influencing effectiveness. Int J Inj Contr Saf Promot, 2007, 14(4): 241-250.
39.	van Dulmen S, Sluijs E, van Dijk L, et al. Patient adherence to medical treatment: A review of reviews. BMC Health Serv Res, 2007, 7: 55.
40.	Autti-Rämö I, Suoranta J, Anttila H, et al. Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy: an overview of review articles. Am J Phys Med Rehabil, 2006, 85(1): 89-103.
41.	Walker AE, McLeer SK; DAMOCLES Group. Small group processes relevant to data monitoring committees in controlled clinical trials: an overview of reviews. Clin Trials, 2004, 1(3): 282-296.
42.	Linde K, Vickers A, Hondras M, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 1: acupuncture. BMC Complement Altern Med, 2001, 1: 3.
43.	Linde K, Vickers A, Hondras M, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 2: herbal medicine. BMC Complement Altern Med, 2001, 1: 5.
44.	Linde K, Hondras M, Vickers A, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy. BMC Complement Altern Med, 2001, 1: 4.
45.	Singh JA, Christensen R, Wells GA, et al. Biologics for rheumatoid arthritis: an overview of Cochrane reviews. Cochrane Database Syst Rev, 2009, (4): CD007848.
46.	Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44: 91-98.
47.	Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44: 1271-1278.
48.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 2007, 7: 10.
49.	Sacks H, Berrier J, Reitman D, et al. Meta-analyses of randomized controlled trials. N Engl J Med, 1987, 316(8): 450-455.
50.	Canadian Coordinating Office for Health Technology Assessment: Proposed Evaluation Tools for COMPUS, Available from https://www.ccohta.ca/compus/compus_pdfCOMPUS_Evaluation_Methodology_draft_e.pdf.
51.	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.
52.	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.
53.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
54.	Holger J Schünemann, Andrew D Oxman, et al. Chapter 12: Interpreting results and drawing conclusions. Version 5.0.2 (updated September 2009). The Cochrane Collaboration, 2009.Available from www.cochrane-handbook.org.
55.	Schünemann H, Bro?ek J, Oxman A, editors. GRADE handbook for grading quality of evidence and strength of recommendation. Version 3.2 [updated March 2009]. The GRADE Working Group, 2009, Available from http://www.cc-ims.net/gradepro.

1. 楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的“系統評價再評價”. 中國循證兒科雜志, 2011, (1): 321-324.
2. Becker LA, Oxman AD. Chapter 22: Overviews of reviews. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.2 (updated September 2009). The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
3. Keus F, Gooszen HG, van Laarhoven CJ. Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. An overview of Cochrane Hepato-Biliary Group reviews. Cochrane Database Syst Rev, 2010, (1): CD008318.
4. Seida JK, Ospina MB, Karkhaneh M, et al. Systematic reviews of psychosocial interventions for autism: an umbrella review. Dev Med Child Neurol, 2009, 51(2): 95-104.
5. Helfand M, Buckley DI, Freeman M, et al. Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U.S. Preventive Services Task Force. Ann Intern Med, 2009, 151(7): 496-507.
6. Mikton C, Butchart A. Child maltreatment prevention: A systematic review of reviews. Bull World Health Organ, 2009, 87(5): 353-361.
7. Peters LW, Kok G, Ten Dam GT, et al. Effective elements of school health promotion across behavioral domains: a systematic review of reviews. BMC Public Health, 2009, 9: 182.
8. Moe RH, Haavardsholm EA, Christie A, et al. Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: an umbrella review of high-quality systematic reviews. Phys Ther, 2007, 87(12): 1716-1227.
9. Jamtvedt G, Dahm KT, Christie A, et al. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Phys Ther, 2008, 88(1): 123-136.
10. Christie A, Jamtvedt G, Dahm KT, et al. Effectiveness of nonpharmacological and nonsurgical interventions for patients with rheumatoid arthritis: an overview of systematic reviews. Phys Ther, 2007, 87(12): 1697-1715.
11. Bradley JM, Moran FM, Elborn JS. Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: An overview of five Cochrane systematic reviews. Respir Med, 2006, 100(2): 191-201.
12. Krishnan JA, Segal JB, Streiff MB, et al. Treatment of venous thromboembolism with low-molecular-weight heparin: a synthesis of the evidence published in systematic literature reviews. RespirMed, 2004, 98(5): 376-386.
13. Smith V, Devane D, Begley CM, et al. A systematic review and quality assessment of systematic reviews of randomised trials of interventions for preventing and treating preterm birth. Eur J Obstet Gynecol Reprod Biol, 2009, 142(1): 3-11.
14. Main C, Thomas S, Ogilvie D, et al. Population tobacco control interventions and their effects on social inequalities in smoking: placing an equity lens on existing systematic reviews. BMC Public Health, 2008, 8: 178.
15. Lewin S, Lavis JN, Oxman AD, et al. Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. Lancet, 2008, 372(9642): 928-939.
16. Franx G, Kroon H, Grimshaw J, et al. Organizational change to transfer knowledge and improve quality and outcomes of care for patients with severe mental illness: a systematic overview of reviews. Can J Psychiatry, 2008, 53(5): 294-305.
17. Bambra C, Gibson M, Sowden AJ, et al. Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment. Prev Med, 2009, 48(5): 454-461.
18. Althabe F, Bergel E, Cafferata ML, et al. Strategies for improving the quality of health care in maternal and child health in low- and middle-income countries: an overview of systematic reviews. Paediatr Perinat Epidemiol, 2008, 22Suppl1: 42-60.
19. Akl EA, Muti P, Schünemann HJ. Anticoagulation in patients with cancer: an overview of reviews. Pol Arch Med Wewn, 2008, 118(4): 183-193.
20. Prior M, Guerin M, Grimmer-Somers K. The effectiveness of clinical guideline implementation strategies - A synthesis of systematic review findings. J Eval Clin Pract, 2008, 14(5): 888-897.
21. Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on nonpharmacological conservative treatment for patellofemoral pain syndrome. J Orthop Sports Phys Ther, 2008, 38(9): 529-541.
22. Clarke M. Systematic review of reviews of risk factors for intracranial aneurysms. Neuroradiology, 2008, 50(8): 653-664.
23. Taylor NF, Dodd KJ, Shields N, et al. Therapeutic exercise in physiotherapy practice is beneficial: a summary of systematic reviews 2002-2005. Aust J Physiother, 2007, 53(1): 7-16.
24. Kuukasjärvi P, Malmivaara A, Halinen M, et al. Overview of systematic reviews on invasive treatment of stable coronary artery disease. Int J Technol Assess Health Care, 2006, 22(2): 219-234.
25. Wensing M, Wollersheim H, Grol R. Organizational interventions to implement improvements in patient care: a structured review of reviews. Implement Sci, 2006, 1: 2.
26. Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther, 2005, 85(11): 1208-1223.
27. Smidt N, de Vet HC, Bouter LM, et al. Effectiveness of exercise therapy: a best-evidence summary of systematic reviews. Aust J Physiother, 2005, 51(2): 71-85.
28. Sohn W, Ismail AI, Tellez M. Efficacy of educational interventions targeting primary care providers'practice behaviors: an overview of published systematic reviews. J Public Health Dent, 2004, 64(3): 164-172.
29. Glazener CM, Evans JH, Peto RE. Treating nocturnal enuresis in children: review of evidence. J Wound Ostomy Continence Nurs, 2004, 31(4): 223-234.
30. Linde K, ter Riet G, Hondras M, et al. Systematic reviews of herbal medicines--an annotated bibliography. Forsch Komplementarmed Klass Naturheilkd, 2003, 10 Suppl 1: 17-27.
31. Grimshaw JM, Shirran L, Thomas R, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care, 2001, 39(8 Suppl 2): II2-45.
32. Furlan AD, Clarke J, Esmail R, et al. A critical review of reviews on the treatment of chronic low back pain. Spine, 2001, 26(7): E155-162.
33. Anttila H, Suoranta J, Malmivaara A, et al. Effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy: a focused review. Am J Phys Med Rehabil, 2008, 87(6): 478-501.
34. Ozbilen M, Adams CE. Systematic overview of Cochrane reviews for anticholinergic effects of antipsychotic drugs . J Clin Psychopharmacol, 2009, 29(2): 141-146.
35. Cnossen JS, ter Riet G, Mol BW, et al. Are tests for predicting pre-eclampsia good enough to make screening viable? A review of reviews and critical appraisal. Acta Obstet Gynecol Scand, 2009, 88(7): 758-765.
36. Law J, Plunkett C, Taylor J, et al. Developing policy in the provision of parenting programmes: Integrating a review of reviews with the perspectives of both parents and professionals. Child Care Health Dev, 2009, 35(3): 302-312.
37. Lemmens V, Oenema A, Knut IK, et al. Effectiveness of smoking cessation interventions among adults: A systematic review of reviews. Eur J Cancer Prev, 2008, 17(6): 535-544.
38. Nilsen P, Yorkston E. Uncovering evidence on community-based injury prevention: A review of programme effectiveness and factors influencing effectiveness. Int J Inj Contr Saf Promot, 2007, 14(4): 241-250.
39. van Dulmen S, Sluijs E, van Dijk L, et al. Patient adherence to medical treatment: A review of reviews. BMC Health Serv Res, 2007, 7: 55.
40. Autti-Rämö I, Suoranta J, Anttila H, et al. Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy: an overview of review articles. Am J Phys Med Rehabil, 2006, 85(1): 89-103.
41. Walker AE, McLeer SK; DAMOCLES Group. Small group processes relevant to data monitoring committees in controlled clinical trials: an overview of reviews. Clin Trials, 2004, 1(3): 282-296.
42. Linde K, Vickers A, Hondras M, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 1: acupuncture. BMC Complement Altern Med, 2001, 1: 3.
43. Linde K, Vickers A, Hondras M, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 2: herbal medicine. BMC Complement Altern Med, 2001, 1: 5.
44. Linde K, Hondras M, Vickers A, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy. BMC Complement Altern Med, 2001, 1: 4.
45. Singh JA, Christensen R, Wells GA, et al. Biologics for rheumatoid arthritis: an overview of Cochrane reviews. Cochrane Database Syst Rev, 2009, (4): CD007848.
46. Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44: 91-98.
47. Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44: 1271-1278.
48. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 2007, 7: 10.
49. Sacks H, Berrier J, Reitman D, et al. Meta-analyses of randomized controlled trials. N Engl J Med, 1987, 316(8): 450-455.
50. Canadian Coordinating Office for Health Technology Assessment: Proposed Evaluation Tools for COMPUS, Available from https://www.ccohta.ca/compus/compus_pdfCOMPUS_Evaluation_Methodology_draft_e.pdf.
51. 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.
52. 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.
53. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
54. Holger J Schünemann, Andrew D Oxman, et al. Chapter 12: Interpreting results and drawing conclusions. Version 5.0.2 (updated September 2009). The Cochrane Collaboration, 2009.Available from www.cochrane-handbook.org.
55. Schünemann H, Bro?ek J, Oxman A, editors. GRADE handbook for grading quality of evidence and strength of recommendation. Version 3.2 [updated March 2009]. The GRADE Working Group, 2009, Available from http://www.cc-ims.net/gradepro.

《中國循證醫學雜志》

系統評價再評價納入研究的質量評價方法調查

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《中國循證醫學雜志》

系統評價再評價納入研究的質量評價方法調查

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