Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Ohio 44195, USA.
Am J Gastroenterol. 2010 Jan;105(1):14-32; quiz 33. doi: 10.1038/ajg.2009.593. Epub 2009 Nov 10.
These recommendations provide a data-supported approach. They are based on the following: (i) a formal review and analysis of the recently published world literature on the topic (Medline search); (ii) American College of Physicians Manual for Assessing Health Practices and Designing Practice Guidelines (1); (iii) guideline policies, including the American Association for the Study of Liver Diseases (AASLD) Policy on the development and use of practice guidelines and the AGA Policy Statement on Guidelines (2); and (iv) the experience of the authors in the specified topic. Intended for use by physicians, these recommendations suggest preferred approaches to the diagnostic, therapeutic, and preventive aspects of care. They are intended to be flexible, in contrast to the standards of care, which are inflexible policies to be followed in every case. Specific recommendations are based on relevant published information. To more fully characterize the quality of evidence supporting the recommendations, the Practice Guideline Committee of the AASLD requires a Class (reflecting the benefit vs. risk) and Level (assessing the strength or certainty) of Evidence to be assigned and reported with each recommendation (Table 1, adapted from the American College of Cardiology and the American Heart Association Practice Guidelines) (3,4).
这些建议提供了一种基于数据的方法。它们基于以下几点:(i)对最近发表的关于该主题的世界文献进行正式审查和分析(Medline 搜索);(ii)美国医师学会评估医疗实践和制定实践指南手册(1);(iii)指南政策,包括美国肝病研究协会(AASLD)制定和使用实践指南的政策以及 AGA 指南声明(2);以及(iv)作者在指定主题方面的经验。这些建议旨在为医生提供诊断、治疗和预防护理方面的首选方法。它们旨在具有灵活性,与护理标准形成对比,后者是在每种情况下都必须遵循的僵化政策。具体建议基于相关的已发表信息。为了更全面地描述支持建议的证据质量,AASLD 的实践指南委员会要求为每个建议分配并报告一个证据的类别(反映获益与风险)和级别(评估强度或确定性)(表 1,改编自美国心脏病学会和美国心脏协会实践指南)(3,4)。