We require even more inclusive stud

We require even more inclusive studies than this one if we are to define severity. Murray and colleagues state that there was poor inter-rater reliability in judging severity. They have made this observation after having excluded from their cohort almost all patients we would normally consider at risk: diabetics, immunocompromised patients, or those they considered a priori to have a severe infection. It might be difficult to further break down grades of severity when the above groups are excluded. Given the unreliability of “severity assessment,” future studies should not exclude those traditional high-risk patients, or at least should limit exclusion criteria to enroll the most externally valid patient sample. We have once again learned that what was thought to be simple is not. Evidence is required to better guide the clinician — at times I wonder if I know anything at all.

結果 (繁體中文) 2:

瞭解情況

結果 (繁體中文) 3:

如果要定義嚴重性，我們需要比這項研究更具包容性的研究。默里和他的同事說，在判斷嚴重程度時，評分者之間的可靠性很差。他們在排除了幾乎所有我們通常認為有危險的患者（糖尿病患者、免疫缺陷患者或那些他們認為有嚴重感染的先天性患者）後，進行了這項觀察。如果排除上述兩組，可能很難進一步細分嚴重程度等級。鑒於“嚴重性評估”的不可靠性，未來的研究不應排除那些傳統的高危患者，或者至少應限制排除標準，以納入最外部有效的患者樣本。我們再次認識到，被認為簡單的事情並非如此。需要證據來更好地指導臨床醫生——有時我懷疑自己是否知道什麼。