眼科医生对循证医学证据分级的认知和实践情况调查

目的 了解眼科医生对循证医学证据分级的认知与态度，为临床更好地加强循证临床决策实践提供参考。设计 问卷调查。研究对象 参加第十八次全国眼科学术大会的眼科医生233名。 方法 采用问卷对233名眼科医生进行调查，调查内容包括：调查对象的基本信息、对循证医学证据分级的了解程度、及其对待证据分级的态度，并分别按学历、职称、医院等级、医院所在城市类型及医院类型分组，对各组调查对象对循证医学证据分级的了解程度及态度进行组间比较。主要指标 调查对象对循证医学证据分级的了解程度，包括其对了解程度的自评等级以及对具体问题的回答正确率；调查对象对循证医学证据分级的态度。结果 共发放问卷233份，收回有效问卷214份（91.8%）。48.3%的调查对象认为临床实践应该以循证医学内容理念为主；25.1%的人仍坚持临床实践应该以传统经验医学为主。调查对象自我评估对证据分级非常了解的仅占1.3%，不太了解或很不了解的占72.4%；学历、医院等级越高，其对证据分级的了解程度（自评）越高。进而分析其对证据分级具体内容了解程度发现，调查对象对证据分级所包括的不同类型、新九级证据中最高等级的证据、治疗措施最佳评价证据、临床药物不良反应最佳等级证据、能为治疗问题提供质量最好答案的研究设计五个问题的回答，正确率分别为0.9%、41.3%、41.5%、6.9%、12.7%；来自综合医院的学历较高的眼科医生，对循证医学新九级证据分级、评价治疗措施的最佳证据等问题的回答相对较好。此外，65.4%的眼科医生认为，证据分级对指导临床实践非常重要或比较重要，且无人认为其对临床实践很不重要。结论 眼科医生对证据分级的认知情况一般，但大部分人已认识到证据分级对指导临床的重要性，今后需要从本科阶段即开始加强证据分级、临床决策方面的培训，并采取相应的措施鼓励眼科医生临床实践中合理应用证据分级。

Survey of ophthalmologists’ cognition and practice on grading of evidence in evidence-based medicine

Objective To survey the status of the cognition and attitude of grading of evidence  in evidence-based medicine in ophthalmologists. Design Questionnaire survey. Participants Two hundred and thirty-three ophthalmologists presented in the 18th Congress of Chinese Ophthalmological Society. Methods 233 ophthalmologists were surveyed by a self-made questionnaire, including their basic information and their cognition and attitude of grading of evidence in evidence-based medicine. Besides, comparison was made between different groups by educational degree, medical title, the level of their hospital, the type of their hospital and city respectively. Main Outcome Measure The cognition and attitude of grading of evidence. As for the cognition, both self-evaluation of the cognition of grading of evidence and the accuracy of concerned specific questions were included. Results A total of 233 questionnaires were distributed, and 214 valid questionnaires were returned (the rate of effective questionnaires is 91.8%).  48.3% of the respondents believe that we should base clinical practice on evidence based medicine while the traditional clinical practice is complementary. But 25.1% of them stand on the opposite side. The percentage of the respondents choosing “well known” about grading of evidence is only 1.3 while those who choose “not-known” or “poorly-known” account for 72.4%. The ophthalmologists with a higher degree or higher level of the hospital they work in evaluate themselves higher level of the acknowledge of grading of evidence. The accuracy of five questions about its details is 0.9, 41.3, 41.5, 6.9, 12.7 percent respectively. The comparison among groups by educational degree, medical title, the level of their hospital, the type of their hospital and city respectively is also consistent with the result above. Besides, 65.4% of respondents think the grading of evidence “vital” or “certain important” while nobody see it as no importance to clinical practice. Conclusion The current cognitions of ophthalmologists on grading of evidence is not very well but most of them have recognized the importance of it to clinical practice. Training about grading of evidence should be started from the stage of undergraduate on. Besides, it’s also emergent to take measures to promote the practicing of grading of evidence in clinic adequately.