临床糖尿病管理指南中的因果语言跳跃
Causal language jumps in clinical practice guidelines for diabetes management
AI总结：
本研究发现糖尿病管理指南中存在普遍的因果语言跳跃现象，需通过良好的因果推断实践来支持。
摘要：
临床实践指南旨在指导临床实践，通常包含因果语言。有时指南会做出或要求比所依赖的参考文献中更强的因果主张，这种现象我们称为'因果语言跳跃'。我们评估了糖尿病指南及其所引用的文献中因果性强度，以确定跳跃模式。我们随机选取了四个糖尿病指南中的300条指南陈述。我们使用现有的量表对陈述中的因果强度以及这些陈述所支持的建议的因果依赖性进行了评分。在引用的原始研究中，同样进行了评估。我们还评估了它们在报告目标试验模拟（TTE）组件方面的可靠性作为代理。在所选陈述中，114条（38.0%）是因果性的，其中76条（66.7%）表达了强因果性。27.2%（31/114）的因果指南陈述表现出'因果语言跳跃'，而83条指南建议中34.9%（29/83）无法有效支持。在53项可供TTE评分的研究中，大多数没有详细报告治疗分配和因果对比。我们的发现表明，糖尿病指南中存在普遍的因果语言跳跃。虽然这些跳跃有时是不可避免的，但它们应始终通过良好的因果推断实践来支持。
英文摘要：
Clinical practice guidelines are designed to guide clinical practice and involve causal language. Sometimes guidelines make or require stronger causal claims than those in the references they rely on, a phenomenon we refer to as 'causal language jump'. We evaluated the strength of expressed causation in diabetes guidelines and the evidence they reference to assess the pattern of jumps. We randomly sampled 300 guideline statements from four diabetes guidelines. We rated the causation strength in the statements and the dependence on causation in recommendations supported by these statements using existing scales. Among the causal statements, the cited original studies were similarly assessed. We also assessed how well they report target trial emulation (TTE) components as a proxy for reliability. Of the sampled statements, 114 (38.0%) were causal, and 76 (66.7%) expressed strong causation. 27.2% (31/114) of causal guideline statements demonstrated a "causal language jump", and 34.9% (29/83) of guideline recommendations cannot be effectively supported. Of the 53 eligible studies for TTE rating, most did not report treatment assignment and causal contrast in detail. Our findings suggest causal language jumps were common among diabetes guidelines. While these jumps are sometimes inevitable, they should always be supported by good causal inference practices.
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