Irani Jacques, Brown Christian, Van der Meulen Jan, Emberton Mark
Service d'Urologie, CHU La Milétrie, Poitiers, France.
Prog Urol. 2004 Feb;14(1):29-32.
Many clinical practice guidelines (CPG) have been developed over the last decade for the management of benign prostatic hyperplasia (BPH) and associated lower urinary tract disorders. The purpose of this study was to analyse CPG published on the web until the end of 2001 and to compare their content and their methodology of development by using a validated evaluation tool. methodologies of development of CPG and their content using a validated tool.
The methodology of elaboration and presentation of CPG was insufficient in the majority of CPGs. The type and number of diagnostic examinations recommended by each CPG were very variable. A consensus concerning treatment was reached at the cost of poorly defined criteria, apart from complications of BPH.
The considerable number of men potentially eligible for management of voiding disorders related to BPH in the years to come will constitute a substantial medico-economic burden. Consensual rationalisation of this management by urologists in order to ensure practical application of the guidelines would limit expenditure without decreasing the quality of patient management. However, our study showed limited coherence between the various CPG, suggesting that rationalisation should first be applied to the method of development of CPG.
在过去十年中，已经制定了许多临床实践指南（CPG）用于良性前列腺增生（BPH）及相关下尿路疾病的管理。本研究的目的是分析截至2001年底在网上发布的CPG，并使用经过验证的评估工具比较它们的内容及其制定方法。使用经过验证的工具分析CPG的制定方法及其内容。
大多数CPG在制定和呈现方法上存在不足。每个CPG推荐的诊断检查的类型和数量差异很大。除了BPH的并发症外，关于治疗达成了共识，但代价是标准定义不明确。
在未来几年中，大量可能适合管理与BPH相关排尿障碍的男性将构成巨大的医疗经济负担。泌尿科医生对这种管理进行共识合理化，以确保指南的实际应用，将在不降低患者管理质量的情况下限制支出。然而，我们的研究表明，各种CPG之间的一致性有限，这表明合理化应首先应用于CPG的制定方法。
