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促进癌症患者贫血的循证管理:基于欧洲癌症研究与治疗组织(EORTC)指南的网络临床指导系统 RESPOND 的背景、开发及科学验证

Promoting evidence-based management of anemia in cancer patients: background, development, and scientific validation of RESPOND, a web-based clinical guidance system based on the EORTC guidelines.

作者信息

Aapro Matti, Van Erps Joanna, MacDonald Karen, Soubeyran Pierre, Turner Matthew, Muenzberg Michael, Dunlop Robert, Warrinnier Hans, Abraham Ivo

机构信息

Institut Multidisciplinaire d'Oncology, Clinique de Genolier, 1 Route du Muids, Genolier, Switzerland.

出版信息

Crit Rev Oncol Hematol. 2008 Jan;65(1):32-42. doi: 10.1016/j.critrevonc.2007.05.002. Epub 2007 Jun 13.

Abstract

The 2006 EORTC guidelines for erythropoietic proteins in cancer-related anemia provide the most up-to-date assessment of the evidence base. Considering general concerns in medicine about clinicians' adoption of evidence-based guidelines, it is critical to find ways of bringing guidelines to the point of care. We describe the rationale behind RESPOND, a web-based clinical guidance system based on the EORTC guidelines, and the methodologies of two studies conducted to validate the system. In a first descriptive study, experts are asked to rate the accuracy of every algorithm derived from the guidelines. In a second step and using a hybrid matched pre-post design, separate retrospective and prospective patient cohorts matched by type of cancer and similarity of chemotherapy regimen (33 pairs) are used to examine the extent to which clinicians' practice patterns converge with the EORTC guidelines when they use or not use the RESPOND system. It is hypothesized that these studies will provide the necessary validation for RESPOND as an evidence-based clinical support tool.

摘要

2006年欧洲癌症研究与治疗组织(EORTC)关于癌症相关性贫血中促红细胞生成蛋白的指南提供了对证据基础的最新评估。鉴于医学领域普遍关注临床医生对循证指南的采用情况,找到将指南应用于临床护理点的方法至关重要。我们描述了基于EORTC指南的网络临床指导系统RESPOND背后的基本原理,以及为验证该系统而进行的两项研究的方法。在第一项描述性研究中,要求专家对从指南中得出的每个算法的准确性进行评分。在第二步中,使用混合匹配的前后设计,通过癌症类型和化疗方案相似性匹配的单独回顾性和前瞻性患者队列(33对),来检验临床医生在使用或不使用RESPOND系统时其实践模式与EORTC指南的契合程度。假设这些研究将为RESPOND作为循证临床支持工具提供必要的验证。

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