McAlister William Howard, Wingert Timothy A, Weaver Jeffrey L, Hanson Heather D, Amos John F
University of Missouri-St. Louis College of Optometry, St. Louis, Missouri, USA.
Optometry. 2006 Dec;77(12):622-8. doi: 10.1016/j.optm.2006.08.001.
The process of developing the American Optometric Association's (AOA) Optometric Clinical Practice Guidelines began in 1989 under the direction of John F. Amos, O.D., M.S., then chair of the AOA's Clinical Care Center. The guideline development process used by the AOA was modeled after the recommendations established by the Agency for Health Care Policy and Research in response to the federal government encouraging health care groups to develop clinical guidelines to enhance the quality, appropriateness, and effectiveness of health care. The guideline topics were chosen for their importance in the education of members, health care payers, and state legislators. A principal author and a consensus panel of experts then were chosen for each subject area. This group was responsible for transforming the latest scientific research and expert judgment into a document that would apply to everyday optometric practice. Thirteen guidelines were developed and mailed to AOA members in 1994 and 1995. Additional guidelines were mailed as they were approved. Currently, there are 20 guidelines available.
A survey was mailed to the executive director of the optometric association of each state and the District of Columbia and to the chief of optometry of each of the federal services. Telephone follow-up was made to nonrespondents, and an additional copy of the survey was mailed to them with telephone follow-up again taking place for those who did not respond.
Forty-three of the surveys were returned for a response rate of 78%. Seventy-six percent of the respondents stated that they had received the guidelines. The sections that were found most useful to the respondents were those related to Description and Classification, Basis of Treatment, and Treatment Options. The guidelines were most often used by these groups to improve the quality of eye care, expand optometric involvement in health programs, affect public policy, and overcome problems with insurance groups.
Optometric organizations have found the clinical practice guidelines useful beyond their primary goal of enhancing the quality of patient care. They have been used effectively to help educate other parties about optometry and its role as a primary health care profession.
美国验光协会（AOA）验光临床实践指南的制定过程始于1989年，由当时AOA临床护理中心主任约翰·F·阿莫斯（John F. Amos）博士、理学硕士指导。AOA采用的指南制定过程是仿照医疗保健政策与研究机构制定的建议进行的，该机构是应联邦政府鼓励医疗保健团体制定临床指南以提高医疗保健质量、适当性和有效性的要求而设立的。指南主题的选择是基于其在会员教育、医疗保健支付方和州立法者教育方面的重要性。然后为每个主题领域挑选了一位主要作者和一个专家共识小组。该小组负责将最新的科学研究和专家判断转化为适用于日常验光实践的文件。1994年和1995年制定了13项指南并邮寄给AOA会员。随着新指南的批准，也会将其邮寄出去。目前，共有20项指南可供使用。
向每个州和哥伦比亚特区的验光协会执行董事以及每个联邦服务部门的验光主管邮寄了一份调查问卷。对未回复者进行电话跟进，并再次向他们邮寄一份调查问卷副本，对仍未回复者再次进行电话跟进。
共收回43份调查问卷，回复率为78%。76%的受访者表示他们收到了这些指南。受访者认为最有用的部分是与描述与分类、治疗依据和治疗选择相关的部分。这些团体最常使用这些指南来提高眼部护理质量、扩大验光师在健康项目中的参与度、影响公共政策以及解决与保险团体相关的问题。
验光组织发现临床实践指南除了在提高患者护理质量这一主要目标方面有用外，还有其他作用。它们已被有效地用于帮助向其他各方宣传验光以及验光作为初级卫生保健专业的作用。
