Bergmann-Krauss Barbara, Micheelis Wolfgang, Szecsenyi Joachim
Zahnärztliche Zentralstelle Qualitätssicherung (ZZQ) im IDZ, Köln.
Z Evid Fortbild Qual Gesundhwes. 2010;104(7):599-604. doi: 10.1016/j.zefq.2009.11.003. Epub 2009 Dec 24.
The discussion about the advantages of evidence-based guidelines in daily dental practice is a matter of current interest. In this report three high-quality S3 level pilot guidelines which have been developed in dental medicine were evaluated under practice conditions. Quality circles in the city of Hamburg readily accepted to join this survey. By means of a questionnaire before and after a 4-month field test in dental practices the participants of quality circles were interviewed about their attitude towards guidelines and to the application of the guidelines. In addition, the experience gained with the application of the guidelines was incorporated into a group discussion with moderators of quality circles. The inclusion of quantitative and qualitative methods enabled a recording of the complete range of differentiated opinions concerning the application of guidelines. The results show that the concerns expressed by participants can be reduced by integrating guidelines in their everyday clinical practice. A strength and weakness analysis demonstrates that the quality circle moderators' attitudes towards approved guidelines range from rather positive to ambivalent. Field testing by quality circles proves to be a sound method for evaluating the acceptance of guidelines in daily practice.
关于循证指南在日常牙科实践中的优势的讨论是当前人们感兴趣的话题。在本报告中，对牙科医学领域制定的三项高质量S3级试点指南在实际应用条件下进行了评估。汉堡市的质量改进小组欣然接受参与这项调查。通过在牙科诊所进行为期4个月的实地测试前后发放问卷，对质量改进小组的参与者就他们对指南的态度以及指南的应用情况进行了访谈。此外，将指南应用过程中获得的经验纳入与质量改进小组主持人的小组讨论中。定量和定性方法的结合使得能够记录关于指南应用的各种不同意见。结果表明，通过将指南纳入日常临床实践，参与者所表达的担忧可以得到缓解。优势和劣势分析表明，质量改进小组主持人对已批准指南的态度从相当积极到矛盾不一。质量改进小组进行的实地测试被证明是评估日常实践中指南接受度的一种可靠方法。
