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良性前列腺增生症指南在临床实践中的转化

Translation of benign prostatic hyperplasia guidelines into clinical practice.

作者信息

Gravas Stavros, Tzortzis Vassilios, Melekos Michael D

机构信息

Department of Urology, University Hospital of Larissa, Larissa, Greece.

出版信息

Curr Opin Urol. 2008 Jan;18(1):56-60. doi: 10.1097/MOU.0b013e3282f13bbf.

Abstract

PURPOSE OF REVIEW

The aim of this article is to describe the current position of clinical practice guidelines for benign prostatic hyperplasia in daily management and identify the potential barriers that may hinder the implementation of guidelines into clinical practice.

RECENT FINDINGS

Recent studies have attempted to compare and grade benign prostatic hyperplasia clinical practice guidelines using appraisal instruments underlining the issues of quality and updates of guidelines. Surveys have evaluated the adoption of guidelines from the urological community and recent studies have made major contributions to our knowledge of the translation of evidence to daily practice.

SUMMARY

Numerous clinical practice guidelines (both national and international) for benign prostatic hyperplasia exist. High methodological quality clinical practice guidelines are likely to be the most beneficial to patients and strength of recommendations depends on available evidence. Efforts to implement guidelines are not always successful and a considerable variation especially in diagnostic assessment of benign prostatic hyperplasia has been reported. Difficulties in translation of benign prostatic hyperplasia guidelines into clinical practice are related to lack of knowledge but also to differences in routine practices, beliefs, cost, availability, and reimbursement policy. Bridging the implementation gap represents a challenging task for clinical practice guideline supporters.

摘要

综述目的

本文旨在描述良性前列腺增生临床实践指南在日常管理中的当前地位,并确定可能阻碍指南在临床实践中实施的潜在障碍。

最新研究发现

近期研究试图使用评估工具对良性前列腺增生临床实践指南进行比较和分级,强调指南的质量和更新问题。调查评估了泌尿外科界对指南的采用情况,近期研究为我们将证据转化为日常实践的认识做出了重大贡献。

总结

存在许多关于良性前列腺增生的临床实践指南(包括国内和国际的)。方法学质量高的临床实践指南可能对患者最有益,推荐强度取决于现有证据。实施指南的努力并不总是成功的,据报道,尤其是在良性前列腺增生的诊断评估方面存在相当大的差异。将良性前列腺增生指南转化为临床实践的困难不仅与知识缺乏有关,还与常规做法、观念、成本、可及性和报销政策的差异有关。弥合实施差距对临床实践指南支持者来说是一项具有挑战性的任务。

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