Mokkink Lidwine B, van der Lee Johanna H, Grootenhuis Martha A, Offringa Martin, Heymans Hugo S A
Psychosocial Department, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Eur J Pediatr. 2008 Dec;167(12):1441-7. doi: 10.1007/s00431-008-0697-y. Epub 2008 Mar 14.
A national consensus procedure was organised to define chronic diseases and health conditions in childhood. Based on (1) a systematic literature search on the definitions of chronic conditions in childhood and (2) a theoretical framework of determinants and indicators of health conditions, a definition of chronic conditions in childhood was proposed. This proposal was subsequently modified according to the comments received from 21 Dutch experts (clinicians, researchers and representatives of patient organisations) in two written consultation rounds and one national meeting, until consensus was reached. Consensus was attained on a definition consisting of four criteria: a disease or condition is considered to be a chronic condition in childhood if: (1) it occurs in children aged 0 up to 18 years; (2) the diagnosis is based on medical scientific knowledge and can be established using reproducible and valid methods or instruments according to professional standards; (3) it is not (yet) curable or, for mental health conditions, if it is highly resistant to treatment and (4) it has been present for longer than three months or it will, very probably, last longer than three months, or it has occurred three times or more during the past year and will probably reoccur. This definition was operationalised using the ICD-10 classification of the World Health Organisation (WHO; International Statistical Classification of Diseases and Related Health Problems [ICD], 10th revision, Geneva, Switzerland, 1992). By this systematic and thorough procedure, national consensus on a comprehensive definition of chronic conditions in children which can be used for epidemiological research was reached.
组织了一项全国性的共识程序，以界定儿童期的慢性病和健康状况。基于（1）对儿童期慢性病定义的系统文献检索，以及（2）健康状况的决定因素和指标的理论框架，提出了儿童期慢性病的定义。随后，根据在两轮书面咨询和一次全国会议中从21名荷兰专家（临床医生、研究人员和患者组织代表）收到的意见，对该提案进行了修改，直至达成共识。就一项包含四项标准的定义达成了共识：如果一种疾病或状况符合以下条件，则被视为儿童期慢性病：（1）发生在0至18岁的儿童中；（2）诊断基于医学科学知识，并且可以根据专业标准使用可重复且有效的方法或工具来确定；（3）它尚未治愈，或者对于心理健康状况而言，如果它对治疗具有高度抗性，以及（4）它已经存在超过三个月，或者很可能持续超过三个月，或者在过去一年中发生了三次或更多次并且可能会再次发生。该定义使用世界卫生组织（WHO；《国际疾病和相关健康问题统计分类》[ICD]，第10版，瑞士日内瓦，1992年）的ICD - 10分类进行操作化。通过这一系统而全面的程序，就可用于流行病学研究的儿童慢性病综合定义达成了全国共识。
