Fernández-Benítez M, Ibero Iborra M, Sanz Ortega J, Garde Garde J
Clínica Universidad de Navarra, Pamplona, Spain.
Allergol Immunopathol (Madr). 2010 Nov-Dec;38(6):295-9. doi: 10.1016/j.aller.2010.02.003. Epub 2010 May 12.
From the paediatric point of view, we have undertaken two Delphi studies into bronchial asthma. The first is related to the consensus known as the consensus document of the five associations. The second is more recent and has been undertaken with GEMA (the Spanish Guidelines on the Management of Asthma). The aim of this paper is to carry out a descriptive study comparing the 2 Delphi processes and to objectively assess if in some way behaviour over the past two years has changed as far as expert opinion is concerned. In the consensus document those points giving rise to most controversy were the treatment of children under three years of age and treatment with immunotherapy in allergic asthma. It is also necessary to highlight how important it was at that particular point in time to define the phenotypes of wheezing and the predictive index of asthma in children of less than 3 years of age. Of the 52 questions in the questionnaire, in 13.6% the panel of experts reached no consensus in their positions. Following GEMA the Delphi methodology, 56 questions were asked in the first round of the questionnaire, and consensus was reached in 87.5%. As regards the paediatric part relating to diagnosis and treatment in children, agreement was reached on all the questions in the first round. Agreement was reached in 8.92% questions in the second round. Clinical guidelines and consensus documents can modify behaviour towards an illness, both in the diagnosis and treatment.
从儿科角度来看，我们针对支气管哮喘开展了两项德尔菲研究。第一项研究与被称为五个协会共识文件的共识相关。第二项研究是最近开展的，是与西班牙哮喘管理指南（GEMA）合作进行的。本文的目的是进行一项描述性研究，比较这两个德尔菲过程，并客观评估就专家意见而言，过去两年的行为是否在某种程度上发生了变化。在共识文件中，引发最多争议的要点是三岁以下儿童的治疗以及过敏性哮喘的免疫疗法治疗。还必须强调在那个特定时间点定义喘息的表型以及三岁以下儿童哮喘预测指数的重要性。在问卷的52个问题中，13.6%的问题专家小组未达成一致立场。遵循GEMA的德尔菲方法，问卷第一轮提出了56个问题，达成共识的比例为87.5%。关于儿童诊断和治疗的儿科部分，第一轮所有问题都达成了一致。第二轮8.92%的问题达成了一致。临床指南和共识文件可以改变对疾病的诊断和治疗行为。
