切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 91 -95. doi: 10.3877/cma.j.issn.1674-134X.2018.01.016

所属专题: 文献 指南共识

综述

真实世界研究在骨关节炎临床实践指南制定中的作用与思考
邢丹1, 林剑浩1,()   
  1. 1. 100044 北京大学人民医院骨关节科,北京大学关节病研究所
  • 收稿日期:2017-06-30 出版日期:2018-02-01
  • 通信作者: 林剑浩
  • 基金资助:
    国家自然科学基金(81501919)

Real-world research in developing clinical practice guidelines for osteoarthritis

Dan Xing1, Jianhao Lin1,()   

  1. 1. Arthritis Clinic & Research Center, Peking University People′s Hospital, Peking University, Beijing 100044, China
  • Received:2017-06-30 Published:2018-02-01
  • Corresponding author: Jianhao Lin
  • About author:
    Corresponding author: Lin Jianhao, Email:
引用本文:

邢丹, 林剑浩. 真实世界研究在骨关节炎临床实践指南制定中的作用与思考[J]. 中华关节外科杂志(电子版), 2018, 12(01): 91-95.

Dan Xing, Jianhao Lin. Real-world research in developing clinical practice guidelines for osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(01): 91-95.

真实世界研究正在成为医疗卫生领域关注的重点,尤其是其对于临床决策的作用和意义。在已发布的几部骨关节炎临床实践指南中,针对同一临床问题的推荐意见等级存在差别。这种差异可能与证据的来源以及评价方法有关。传统临床随机对照试验由于研究对象在选择方面的限制可能导致无法将研究结果从部分推广到整体。为了阐释真实世界研究的概念以及说明真实世界研究在临床实践指南制定方面的作用,本综述以现有的骨关节炎临床实践指南为例,对真实世界研究的一些重要内容概述并对其在指南制定中发挥的可能作用进行探讨,以期为未来的临床实践指南制定提供理论指导。

Real world research is becoming the focus in the field of health care, especially its role in clinical decision-making. In several published clinical practice guidelines for osteoarthritis, there are differences in the levels of recommendation for the same intervention. These discrepancies may be related to the source of the evidence. The present study briefly reviewed the clinical practice guidelines for osteoarthritis to explain the definition of real-world research and its role in developing clinical practice guidelines. The purpose of the present study is to provide theoretical guidance for future clinical practice guidelines.

[1]
Jarow JP. Use of External Controls in Regulatory Decision-Making[J]. Clin Pharmacol Ther, 2017, 101(5):595-596.
[2]
Knottnerus JA,Tugwell P. Real world research[J]. J Clin Epidemiol, 2010, 63(10):1051-1052.
[3]
Gupta S,Wang H,Skolnik N, et al. Treatment dosing patterns and clinical outcomes for patients with type 2 diabetes starting or switching to treatment with insulin glargine (300 units per milliliter) in a real-world setting: a retrospective observational study[J]. Adv Ther, 2018, doi: 10.1007/s12325-017-0651-3.[Epub ahead of print].

URL    
[4]
Zhao YJ,Teng M,Khoo AL, et al. A propensity score matched comparison of biodegradable polymer versus second-generation durable polymer drug-eluting stents in a real-world population[J]. Cardiovasc Ther, 2018, doi: 10.1111/1755-5922.12319.[Epub ahead of print].

URL    
[5]
Shu H,Lu J,Zhang P, et al. Clinical characteristics of type 2 diabetes patients with discordance between HbA1c and fasting plasma glucose in the real world: an analysis of the ORBIT study[J]. Diabetes Metab Res Rev, 2018, doi: 10.1002/dmrr.2977.[Epub ahead of print].

URL    
[6]
De Potter T,Van Herendael H,Balasubramaniam R, et al. Safety and long-term effectiveness of paroxysmal atrial fibrillation ablation with a contact force-sensing catheter: real-world experience from a prospective, multicentre observational cohort registry[J]. Europace, 2018, doi: 10.1093/europace/eux290.[Epub ahead of print].

URL    
[7]
Bartlett SJ,Barnes T,McIvor RA. Integrating patients into meaningful real-world research[J]. Ann Am Thorac Soc, 2014, 11 Suppl 2: S112-117.
[8]
孙鑫,谭婧,唐立, 等. 重新认识真实世界研究[J]. 中国循证医学杂志, 2017, 17(02):126-130.
[9]
Krishnan JA,Schatz M,Apter AJ. A call for action: Comparative effectiveness research in asthma[J]. J Allergy Clin Immunol, 2011, 127(1):123-127.
[10]
Travers J,Marsh S,Williams M, et al. External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?[J]. Thorax, 2007, 62(3):219-223.
[11]
Kardos P,Worsley S,Singh D, et al. Randomized controlled trials and real-world observational studies in evaluating cardiovascular safety of inhaled bronchodilator therapy in COPD[J]. Int J Chron Obstruct Pulmon Dis, 2016, 11:2885-2895.
[12]
Silverman SL. From randomized controlled trials to observational studies[J]. Am J Med, 2009, 122(2):114-120.
[13]
Roche N,Reddel H,Martin R, et al. Quality standards for real-world research. Focus on observational database studies of comparative effectiveness[J]. Ann Am Thorac Soc, 2014, 11 Suppl 2:S99-104.
[14]
Altman RD,Schemitsch E,Bedi A. Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid[J]. Semin Arthritis Rheum, 2015, 45(2):132-139.
[15]
Orchard JW. Systematic review is the highest level of evidence for knee osteoarthritis injection options, not expert society guidelines[J]. Br J Sports Med, 2017, 51(7):622.
[16]
Gold R,Bunce A,Cowburn S, et al. Cardiovascular care guideline implementation in community health centers in Oregon: a mixed-methods analysis of real-world barriers and challenges[J]. BMC Health Serv Res, 2017, 17(1):253.
[17]
Jevsevar D,Donnelly P,Brown GA, et al. Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review of the Evidence[J]. J Bone Joint Surg Am, 2015, 97(24):2047-2060.
[18]
Strand V,McIntyre LF,Beach WR, et al. Safety and efficacy of US-approved viscosupplements for knee osteoarthritis: a systematic review and meta-analysis of randomized, saline-controlled trials[J]. J Pain Res, 2015, 8:217-228.
[19]
Richette P,Chevalier X,Ea HK, et al. Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias[J]. RMD Open, 2015, 1(1):e000071.
[20]
Bannuru RR,Natov NS,Obadan IE, et al. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis[J]. Arthritis Rheum, 2009, 61(12):1704-1711.
[21]
Dasa V,DeKoven M,Sun K, et al. Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database[J]. Drugs Context, 2016, 5:212296.
[22]
Petrella RJ,Wakeford C. Pain relief and improved physical function in knee osteoarthritis patients receiving ongoing hylan G-F 20, a high-molecular-weight hyaluronan, versus other treatment options: data from a large real-world longitudinal cohort in Canada[J]. Drug Des Devel Ther, 2015, 9:5633-5640.
[23]
Price D,Chisholm A,van der Molen T, et al. Reassessing the evidence hierarchy in asthma: evaluating comparative effectiveness[J]. Curr Allergy Asthma Rep, 2011, 11(6):526-538.
[24]
Doghramji PP,Fermer S,Wood R, et al. Management of gout in the real world: current practice versus guideline recommendations[J]. Postgrad Med, 2016, 128(1):106-114.
[25]
Lian J,Liang Y. Diabetes management in the real world and the impact of adherence to guideline recommendations[J]. Curr Med Res Opin, 2014, 30(11):2233-2240.
[26]
Montie JE. Guideline application and the real world[J]. Urol Oncol, 2014, 32(4):377-379.
[1] 曾铖, 张剑. 抗体药物偶联物在三阴性乳腺癌中的应用[J]. 中华乳腺病杂志(电子版), 2024, 18(03): 140-145.
[2] 庄若语, 杭明辉, 李文华, 张霆, 侯炜. 膝骨关节炎半定量磁共振评分研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 545-552.
[3] 李志文, 李远志, 李华, 方志远. 糖皮质激素治疗膝骨关节炎疗效的网状Meta分析[J]. 中华关节外科杂志(电子版), 2024, 18(04): 484-496.
[4] 闫泽辉, 狄靖凯, 郭子瑊, 穆昶江, 张智博, 陈帅, 王泽华, 田最, 向川. 膝关节机械感受器在半月板损伤中的功能[J]. 中华关节外科杂志(电子版), 2024, 18(04): 524-531.
[5] 王冰, 孙海宁, 于秀淳, 周珂, 翟凯, 苗族康. 膝骨关节炎的活动衬垫型单髁置换疗效与假体生存率[J]. 中华关节外科杂志(电子版), 2024, 18(03): 337-345.
[6] 张江礼, 刘金辉, 潘西庆, 刘光源, 范虓. 全膝关节置换应用智能辅助手术导航系统治疗膝骨关节炎[J]. 中华关节外科杂志(电子版), 2024, 18(03): 346-351.
[7] 张刚, 秦勇, 黄超, 薛震, 吕松岑. 基于骨关节炎软骨细胞表型转化的新兴治疗靶点[J]. 中华关节外科杂志(电子版), 2024, 18(03): 352-362.
[8] 陈松, 黄玲巧, 余清卿, 魏志鑫, 付琰. 单细胞RNA测序技术在骨关节炎软骨中的研究应用[J]. 中华关节外科杂志(电子版), 2024, 18(03): 363-371.
[9] 王颉, 周游. 二甲双胍治疗骨关节炎的机制及其研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(03): 372-378.
[10] 田志敏, 何淳诺, 李焕玺, 吴昊越, 刘鹏, 乔永杰, 周胜虎, 蓝平衡, 郭氧, 张浩强. 股骨头坏死动物模型研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(03): 383-389.
[11] 阮星星, 黄智渊, 刘芙香, 狄金明. 从临床医师诊治患者的思路出发撰写临床研究论文[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 397-401.
[12] 陈丽璇, 窦培宁, 肖扬. 干细胞治疗早发性卵巢功能不全的现状及未来展望[J]. 中华细胞与干细胞杂志(电子版), 2024, 14(04): 239-248.
[13] 高广涵, 张耀南, 石磊, 王林, 王飞, 郑子天, 王鸿禹, 郭民政, 薛庆云. 膝骨关节炎患者前交叉韧带功能影像学影响因素分析[J]. 中华老年骨科与康复电子杂志, 2024, 10(05): 301-307.
[14] 吴孝琦, 罗飞, 史凡凡, 方青. 移动健康在慢性肌肉骨骼疼痛患者自我管理中的应用进展[J]. 中华老年骨科与康复电子杂志, 2024, 10(04): 251-256.
[15] 楚海强, 杨远游, 任刚. 胰腺癌放射治疗联合其他治疗方法的研究进展[J]. 中华临床医师杂志(电子版), 2024, 18(04): 392-396.
阅读次数
全文


摘要