制定评估全科医疗中稳定性心绞痛、成人哮喘和非胰岛素依赖型糖尿病管理质量的评审标准。
Development of review criteria for assessing the quality of management of stable angina, adult asthma, and non-insulin dependent diabetes mellitus in general practice.
作者信息
Campbell S M, Roland M O, Shekelle P G, Cantrill J A, Buetow S A, Cragg D K
机构信息
National Primary Care Research and Development Centre, University of Manchester, UK.
出版信息
Qual Health Care. 1999 Mar;8(1):6-15. doi: 10.1136/qshc.8.1.6.
Abstract
OBJECTIVE
To develop review criteria to assess the quality of care for three major chronic diseases: adult asthma, stable angina, and non-insulin dependent diabetes mellitus.
SUBJECTS AND METHODS
Modified panel process based upon the RAND/UCLA (University College of Los Angeles) appropriateness method. Three multiprofessional panels made up of general practitioners, hospital specialists, and practice nurses.
RESULTS
The RAND/UCLA appropriateness method of augmenting evidence with expert opinion was used to develop criteria for the care of the three conditions. Of those aspects of care which were rated as necessary by the panels, only 26% (16% asthma, 10% non-insulin dependent diabetes, 40% angina) were subsequently rated by the panels as being based on strong scientific evidence.
CONCLUSION
The results show the importance of a systematic approach to combining evidence with expert opinion to develop review criteria for assessing the quality of three chronic diseases in general practice. The evidence base for the criteria was often incomplete, and explicit methods need to be used to combine evidence with expert opinion where evidence is not available.
摘要
目的
制定评估三种主要慢性病（成人哮喘、稳定型心绞痛和非胰岛素依赖型糖尿病）护理质量的审查标准。
研究对象与方法
基于兰德/加州大学洛杉矶分校（UCLA）适宜性方法的改良专家小组流程。三个多专业专家小组，成员包括全科医生、医院专科医生和执业护士。
结果
采用兰德/加州大学洛杉矶分校通过专家意见补充证据的适宜性方法，制定了这三种疾病的护理标准。在专家小组评定为必要的护理方面中，随后只有26%（哮喘为16%，非胰岛素依赖型糖尿病为10%，心绞痛为40%）被专家小组评定为基于强有力的科学证据。
结论
结果表明，采用系统方法将证据与专家意见相结合，以制定评估全科医疗中三种慢性病护理质量的审查标准非常重要。这些标准的证据基础往往不完整，在缺乏证据时，需要使用明确的方法将证据与专家意见相结合。
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