實證醫學研究之系統性回顧方法評論－療效研究之品質評估

評估研究的品質為從事實證醫學研究，尤其是系統性回顧研究的關鍵步驟所在。回顧者若同時採用不同品質的原著研究，將會影響系統性回顧之最後結果，甚至導致完全相反的結論。當回顧眾多的原著文獻時，從選擇研究的類型開始，直到最後產生臨床醫療或進一步研究的推薦，每一階段都需要做研究之「品質評估」。品質評估的結果將影響到對該研究結果作推論的強度，以及最終在實證醫學上推薦的等級。研究之品質評估必須評估研究本身的內部效度及外部效度，方法上首先須訂出選取原著研究的最低品質要求標準。其次是應用品質檢查表及量表，來詳細審查所選出每一原著研究的細項品質，並釐清品質的差異對研究結果差異性的影響有多大。而療效研究的品質評估，主要聚焦在內部效度的部分。作者將提供有關療效研究之品質評估的方法及工具。至於非療效類的研究亦有其評估標準，本文只作概述介紹。

關鍵字

實證醫學；系統性回顧；品質評估；療效研究

並列摘要

Quality assessment of selected studies is critical to a systematic review, a scientific method applied to evidence-based medicine. Studies with varying quality will significantly impact a final conclusion and, eventually, can lead to incorrect recommendations. In systematic review, quality assessment is essential at each stage from initial selection of literature to final clinical practice and research recommendations. Assessing study quality is to determine internal and external validity. First, reviewers should establish minimal quality requirements for inclusion and exclusion of studies exploring related topics. Then reviewers should develop and apply a quality check list and/or quality scale to examine in detail the quality of each study to clarify the impact of study quality on study outcomes. In effectiveness studies, the principal criteria for study quality are primarily concerned with internal validity. This work introduces a methodology and tools to assess quality of effectiveness studies. This work also provides a brief overview for studies other than effectiveness.

並列關鍵字

Evidence-based medicine ； systematic reviews ； quality assessment ； effectiveness studies

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