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Where Next for Evidence Synthesis of Prognostic Marker Studies? Improving the Quality and Reporting of Primary Studies to Facilitate Clinically Relevant Evidence-Based Results

机译:下一个证据合成预后标志物研究的地方?提高初级研究的质量和报告,以促进临床相关证据的结果

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Prognostic markers can help to identify patients with different risks of specific outcomes, facilitate treatment choice, and aid patient counselling. Unfortunately, within any given disease area, the wealth of conflicting and heterogeneous evidence makes it difficult for the clinician to ascertain the overall evidence about specific markers and how to use them in practice. The application of formal methods (e.g., a systematic review and meta-analysis) of obtaining and synthesising evidence is therefore greatly needed in the prognostic marker field. However, in this chapter we illustrate and discuss the reasons why currently poor standards of design, clinical relevance, and reporting in primary studies limit statistically reliable and clinically relevant evidence-based results for prognostic markers. These problems add to those issues for the statistical analysis in primary studies that are discussed in another chapter in this volume. To help overcome the problems we highlight guidelines for conducting and reporting primary prognostic research, and we particularly discuss why the availability of individual patient data would help realise the evidence-based use of prognostic markers in clinical practice.
机译:预后标志物可以帮助鉴定特定结果的不同风险的患者,促进治疗选择,援助患者咨询。遗憾的是,在任何给定的疾病区域内,临床医生难以确定具体标记的总体证据以及如何在实践中使用它们。因此,在预后标志物领域大大需要正式方法(例如,系统审查和荟萃分析)获得和综合证据。但是,在本章中,我们说明并讨论了当前设计,临床相关性和在初级研究中报告的原因,初步研究限制了预后标志物的统计上可靠和临床相关的基于证据的结果。这些问题增加了在本卷中另一章中讨论的初级研究中统计分析的问题。为了帮助克服这些问题,我们突出了进行的开展和报告初步预后研究的准则,以及我们特别讨论为什么个人患者数据的可用性有助于实现临床实践中预后标志物的基于证据的使用。

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