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本文是《PLoS Medicine》关于卫生系统知证政策指导三篇系列文章的第一篇,阐述了应如何将证据转化为指导,以形成卫生系统政策,并促进临床和公共卫生干预的实施。其要点如下:①薄弱的卫生系统阻碍了有效干预的实施,加强此系统的政策需要基于当前可得的最佳证据;②卫生系统证据最好以政策制定过程参考的指导的形式呈现,但目前卫生系统指导制定质量较差;③将问题、干预及实施相关的研究转化为影响卫生系统组织方式的决策和政策是卫生系统指导制定面临的一个挑战;④制定及时且适用于广大卫生系统利益相关者的指导,并确定评价卫生系统指导质量的方法是另一个挑战;⑤改编现有方法(如用于临床指南的那些方法)制定有意义的建议来应对卫生系统、政策系统及背景的复杂性,尚需进一步研究。
This is the first in a series of three articles in the PLoS Medicine Guide to Health System Validation Policy, explaining how evidence should be translated into guidance to form a health system policy and to promote the implementation of clinical and public health interventions. The main points are as follows: ① Weak health system hinders the implementation of effective intervention. The policy to strengthen this system needs to be based on the best available evidence at present. ② The evidence of health system is best presented in the form of guidance for reference of policy making process, Poor quality of health system guidance; (iii) transformation of research on issues, interventions and implementation into decisions and policies affecting the health system’s organization; and (iii) a challenge to health system guidance development; (iv) development of timely and appropriate health system benefits And identifying ways to assess the quality of health systems guidance is another challenge; ⑤ Adapting existing approaches (such as those used in clinical guidelines) to making meaningful recommendations to address the complexities of health systems, policy systems and contexts , Still need further study.