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首页> 外文期刊>Journal of Health Services Research & Policy >Are decisions by purchasers in an English health district evidence-based?
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Are decisions by purchasers in an English health district evidence-based?

机译：购买者在英国卫生区的决策是否基于证据？

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Objectives: First, to investigate how many decisions by one commissioning body (district health authority) were based on evidence of effectiveness from randomised controlled trials (RCTs) and systematic reviews of RCTs. Second, to investigate whether other types of quantitative studies and qualitative studies could be used as evidence to support commissioning decisions. nnMethod: From three planning documents (for 1997-1998), all statements were identified. Effectiveness questions were constructed from each and used to search for evidence from trials and reviews in the Cochrane Library (Issue 4, 1998). Further searches for other studies (all methodologies) were performed on a subset of decisions and appraised by an independent expert panel. nnResults: A total of 124 decisions were identified of which two-thirds concerned organisation of care. Evidence existed for less than half (48.4%) the decisions, with 33.9% favouring the decision and 14.5% where evidence was either equivocal or unfavourable. From a random subset of ten decisions, relevant non-randomised quantitative studies and qualitative studies were identified for half the decisions. Evidence from economic evaluations was identified for only one decision. nnConclusions: Large gaps in knowledge exist if health care purchasers are to base their decisions on evidence of effectiveness from RCTs. However, other types of evidence can be used to support such decisions. Summaries of research should be published in a format that is accessible to purchasers.
机译：目标：首先，根据一个随机对照试验（RCT）的有效性和对RCT的系统评价，调查一个委托机构（地区卫生当局）的多少决定。第二，调查是否可以将其他类型的定量研究和定性研究用作支持委托决策的证据。 nn方法：从三个计划文档（1997-1998年）中，确定所有陈述。从每个问题中构造出有效性问题，并用于在Cochrane图书馆中从试验和评论中寻找证据（第4期，1998年）。对其他研究（所有方法）的进一步搜索是根据一个决策子集进行的，并由一个独立的专家小组进行评估。结果：总共确定了124个决定，其中三分之二与护理组织有关。不到一半（48.4％）的决策存在证据，其中33.9％的决策赞成，而14.5％的证据模棱两可或不利。从十个决策的随机子集中，确定了一半决策的相关非随机定量研究和定性研究。经济评估的证据仅被确定为一项决定。 nn结论：如果医疗保健购买者要根据RCT的有效性证据做出决策，则知识上存在很大差距。但是，可以使用其他类型的证据来支持此类决策。研究摘要应以购买者可以使用的格式发布。

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