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GRADE Guidelines Series

Overviews:

00: GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology.

J Clin Epidemiol. 2011 Apr;64(4):380-2. 
doi: 10.1016/j.jclinepi.2010.09.011. 
Epub 2010 Dec 24. PubMed PMID: 21185693.

10-13 GRADE guidelines-an introduction to the 10th-13th articles in the series. 

J Clin Epidemiol. 2013 Feb;66(2):121-3. 
doi: 10.1016/j.jclinepi.2012.05.011. 
Epub 2012 Sep 9. PubMed PMID: 22968177.

Monographs:


01: GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. 

J Clin Epidemiol. 2011 Apr;64(4):383-94. 
doi: 10.1016/j.jclinepi.2010.04.026. 
Epub 2010 Dec 31. PubMed PMID: 21195583.

02: GRADE guidelines: 2. Framing the question and deciding on important outcomes. 

J Clin Epidemiol. 2011 Apr;64(4):395-400. 
doi: 10.1016/j.jclinepi.2010.09.012. 
Epub 2010 Dec 30. PubMed PMID: 21194891.

03: GRADE guidelines: 3. Rating the quality of evidence. 

J Clin Epidemiol. 2011 Apr;64(4):401-6. 
doi: 10.1016/j.jclinepi.2010.07.015. 
Epub 2011 Jan 5. PubMed PMID: 21208779.

04: GRADE guidelines: 4. Rating the quality of evidence--study limitations (risk of bias). 

J Clin Epidemiol. 2011 Apr;64(4):407-15. 
doi: 10.1016/j.jclinepi.2010.07.017. 
Epub 2011 Jan 19. PubMed PMID: 21247734.

05: GRADE guidelines: 5. Rating the quality of evidence--publication bias. 

J Clin Epidemiol. 2011 Dec;64(12):1277-82. 
doi: 10.1016/j.jclinepi.2011.01.011. 
Epub 2011 Jul 30. PubMed PMID: 21802904.

06: GRADE guidelines 6. Rating the quality of evidence--imprecision. 

J Clin Epidemiol. 2011 Dec;64(12):1283-93. 
doi: 10.1016/j.jclinepi.2011.01.012. 
Epub 2011 Aug 11. PubMed PMID: 21839614.

07: GRADE guidelines: 7. Rating the quality of evidence--inconsistency. 

J Clin Epidemiol. 2011 Dec;64(12):1294-302. 
doi: 10.1016/j.jclinepi.2011.03.017. 
Epub 2011 Jul 31. PubMed PMID: 21803546.

08: GRADE guidelines: 8. Rating the quality of evidence--indirectness. 

J Clin Epidemiol. 2011 Dec;64(12):1303-10. 
doi: 10.1016/j.jclinepi.2011.04.014. 
Epub 2011 Jul 30. PubMed PMID: 21802903.

09: GRADE guidelines: 9. Rating up the quality of evidence. 

J Clin Epidemiol. 2011 Dec;64(12):1311-6. 
doi: 10.1016/j.jclinepi.2011.06.004. 
Epub 2011 Jul 30. PubMed PMID: 21802902.

10: GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence. 

J Clin Epidemiol. 2013 Feb;66(2):140-50. 
doi: 10.1016/j.jclinepi.2012.04.012. 
Epub 2012 Aug 3. Review. PubMed PMID: 22863410.

11: GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes. 

J Clin Epidemiol. 2013 Feb;66(2):151-7. 
doi: 10.1016/j.jclinepi.2012.01.006. 
Epub 2012 Apr 27. Review. PubMed PMID: 22542023.

12: GRADE guidelines: 12. Preparing summary of findings tables-binary outcomes. 

J Clin Epidemiol. 2013 Feb;66(2):158-72. 
doi: 10.1016/j.jclinepi.2012.01.012. 
Epub 2012 May 18. Review. PubMed PMID: 22609141.

13: GRADE guidelines: 13. Preparing summary of findings tables and evidence profiles-continuous outcomes.

J Clin Epidemiol. 2013 Feb;66(2):173-83. 
doi: 10.1016/j.jclinepi.2012.08.001. Epub 2012 Oct 30. 
Review. Erratum in: J Clin Epidemiol. 2015 Apr;68(4):475. PubMed PMID: 23116689.

14: GRADE guidelines: 14. Going from evidence to recommendations: the significance

and presentation of recommendations. 
J Clin Epidemiol. 2013 Jul;66(7):719-25.
doi: 10.1016/j.jclinepi.2012.03.013. 
Epub 2013 Jan 9. PubMed PMID: 23312392.

15: GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength. 

J Clin Epidemiol. 2013 Jul;66(7):726-35. 
doi: 10.1016/j.jclinepi.2013.02.003. 
Epub 2013 Apr 6. PubMed PMID: 23570745.

16: GRADE Guidelines: 16. GRADE evidence to decision frameworks for tests in clinical practice and public health. 

J Clin Epidemiol. 2016 Aug;76:89-98. 
doi: 10.1016/j.jclinepi.2016.01.032. 
Epub 2016 Feb 27. PubMed PMID: 26931285.

17: GRADE guidelines 17: assessing the risk of bias associated with missing participant outcome data in a body of evidence. 

J Clin Epidemiol. 2017 Jul;87:14-22. 
doi: 10.1016/j.jclinepi.2017.05.005. 
Epub 2017 May 18. PubMed PMID: 28529188.

18: GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence. 

J Clin Epidemiol. 2018 Feb 9. pii: S0895-4356(17)31031-4. 
doi: 10.1016/j.jclinepi.2018.01.012. 
[Epub ahead of print] PubMed PMID: 29432858.

19: GRADE Guidelines: 19. Assessing the certainty of evidence in the importance of outcomes or values and preferences-Risk of bias and indirectness. 

J Clin Epidemiol. 2018 Feb 13. pii: S0895-4356(17)31036-3. 
doi: 10.1016/j.jclinepi.2018.01.013. 
[Epub ahead of print] PubMed PMID: 29452223.

20: GRADE guidelines: 20. Assessing the certainty of evidence in the importance of outcomes or values and preferences-inconsistency, imprecision, and other domains. 

J Clin Epidemiol. 2018 May 22. pii: S0895-4356(17)31061-2. 
doi: 10.1016/j.jclinepi.2018.05.011. 
[Epub ahead of print] PubMed PMID: 29800687.

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氣喘噴劑 列表

氣喘噴劑 列表

● SABA
    Ventolin inhaler 100 mcg/d, 200d
      (salbutamol) 1 puff tidprn

● CS/ LABA
    Foster inh. 100/6 mcg/d, 120d
      (beclomethasone, formoterol) rapid onset and long duration
    Seretide 125 evohaler 125/25 mcg,
      (fluticasone propionate, salmeterol)
    Seretide 250 evohaler 250/25 mcg,
      (fluticasone propionate, salmeterol)
    Symbicort * turbuhaler 120 dose 160/4.5 mcg
      (budesonide, formoterol)

● LAMA/ LABA:
    Berodual MDI 200 puff 20/50 mcg, 200 puff
      (ipratropium, fenoterol)

● LAMA
    Spiriva inh. 2.5 mcg/puff, 60 puff
      (tiotropium) 1puff qd

Equivalent doses:
   Beclomethasone 400 mcg  =  Fluticasone 200 mcg  =
   Mometasone 200/400 mcg  =  Budesonide 400 mcg  =
   Ciclesonide 160 mcg  =  Clenil 400 mcg  =  Qvar 200 mcg.

Binding affinity, reference Dexamethasone 100;
   Budesonide 935;   Ciclesonide 1200;
   Beclomethasone 1345;   Fluticasone propionate 1775;
   Mometasone 2100;   Fluticasone furoate 2980.


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實證醫學大哉問

實證醫學 3E4Q5A 中
5A 的第一個 A = Ask 大哉問!
問聚焦的、臨床上可以回答的問題。

需先釐清問題的型式,包括:

PICO (治療、預防)
  P: patient, population, problem...
      需考量精確的定義、嚴重度、分類、期別...等
  I: intervention
      所關注的介入措施,包括方式、劑量、期間...等
  C: comparison
      比較的介入措施,包括方式、劑量、期間...等
      如果沒有,仍需依當時之標準程序處置
      是否有 placebo 或 sham procedure
  O: outcome
      major/primary: 病人在乎的結果,例如死亡、殘障失能等
      minor/secondary: 較輕微或罕見結果、或是檢驗數值等。
      adverse effects: 介入的副作用
      complications: 疾病的併發症   

PEO (病因、危害)
  P: patient, population, problem...
  E: exposure
      暴露的強度、期間、劑量...等
  O: outcome 

PIRD (診斷)
  P: patient, population, problem...
  I: index test
  R: reference test
      參考標準,或稱黃金標準
  D: diagnostic test accuracy
      sensitivity, specificity, positive and negative likelihood ratio
      ROC curve

CoCoPop (發生率、盛行率)
  Co: condition
      disease, symptom, event, factor...
  Co: context
      geographical, community, cultural...
  Pop: population


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