Madsen Ole Rintek, Faurschou Mikkel, Loft Anne Gitte, Sørensen Inge Juul, Knudsen John Bonde, Baslund Bo, Hansen Annette, Hansen Michael Sejer, Østergaard Mikkel
Department of Internal Medicine C/Rheumatology, Copenhagen University Hospital Gentofte, 2900 Hellerup, Denmark.
Dan Med Bull. 2010 Oct;57(10):A4190.
The aim of this study was to develop 3E (Evidence, Expertise, Exchange) recommendations (RCs) on the use of methotrexate in rheumatic disorders and to assess the agreement among Danish rheumatologists.
Based on a systematic literature review and Delphi votes, national and multinational (MN) RCs were developed by 751 rheumatologists from 17 countries including Denmark, and the degree of agreement among the participants was assessed. Subsequently, a survey regarding the agreement on the MN RCs was sent to all Danish rheumatologists.
A total of 24 Danish RCs were elaborated by 43 rheumatologists at a national meeting. 71-100% (median 94%) of the participants agreed with each of the RCs. A total of 73 rheumatologists answered the survey on the ten MN RCs. On numerical rating scales with values ranging from zero to ten, the median agreement score for each of these RCs ranged from eight to ten. The RCs were already applied in daily practice by 70-100% (median 91%) of the specialists. Any direct conflict between the national and MN RCs was not evident.
Based on evidence and expert opinion in a MN approach, national and MN RCs on methotrexate therapy were developed and a high level of agreement among Danish rheumatologists was evidenced.
本研究的目的是制定关于甲氨蝶呤在风湿性疾病中应用的3E（证据、专业知识、交流）推荐意见（RCs），并评估丹麦风湿病学家之间的一致性。
基于系统的文献综述和德尔菲投票，包括丹麦在内的17个国家的751名风湿病学家制定了国家和跨国（MN）RCs，并评估了参与者之间的一致程度。随后，向所有丹麦风湿病学家发送了一份关于对MN RCs一致性的调查问卷。
43名风湿病学家在一次全国会议上详细阐述了总共24条丹麦RCs。71%-100%（中位数94%）的参与者同意每条RCs。共有73名风湿病学家回答了关于十条MN RCs的调查问卷。在数值范围从0到10的评分量表上，这些RCs每条的中位数一致得分在8到10之间。70%-100%（中位数91%）的专家已在日常实践中应用这些RCs。国家和MN RCs之间没有明显的直接冲突。
基于MN方法中的证据和专家意见，制定了关于甲氨蝶呤治疗的国家和MN RCs，并且证明丹麦风湿病学家之间具有高度的一致性。
