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[德国指南门户网站中关于年龄增长的循证信息:以心力衰竭为例进行比较]

[Evidence-based information concerning increasing age in German guideline portals: comparison using heart failure as an example].

作者信息

Weiss B

机构信息

Anästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.

出版信息

Z Gerontol Geriatr. 2011 Apr;44(2):85-90. doi: 10.1007/s00391-011-0175-4.

DOI:10.1007/s00391-011-0175-4
PMID:21494929
Abstract

The ongoing epidemiological and demographic developments lead to a greater demand for evidence-based information for the practice in health-care provision. Therefore, it was evaluated whether older patients are playing a role in German guidelines, whether there are guidelines on diseases with particular relevance in old age, whether elderly patients are particularly considered in guidelines, and whether the information available in guidelines is easily retrieved. First, an overview is given on portals for guidelines in Germany with free online access. Then, selected results from an analysis of information specifically considering elderly patients of selected registers are presented. There was a lack of information regarding older patients in all guidelines analyzed, apart from the few guidelines specifically addressing old age. Explicit statements explaining the reasons for the lack of information are rare in guidelines. The user of the guidelines, therefore, remains uninformed whether this is because of the lack of available data. From the users' point of view, there should be an online platform providing the complete evidence via shared access. This would clearly improve the overview, thus, facilitating the search for specific issues, e.g., older age and multimorbidity. In addition, there is room for improvement in practical aspects of the use of guidelines, e.g., the standardization of guideline forms and the consolidation of individual guideline portals would clearly assist persons wishing to obtain an overview. Furthermore, most guidelines do not have internal links between content, references, explanation of evidence-based information, and recommendations, which are necessary for effective research.

摘要

当前的流行病学和人口统计学发展态势使得医疗保健实践对循证信息的需求日益增加。因此,对老年患者在德国指南中是否发挥作用、是否存在针对老年期特别相关疾病的指南、指南中是否特别考虑了老年患者以及指南中的信息是否易于获取进行了评估。首先,介绍了德国可免费在线访问的指南门户网站。然后,展示了对特定登记册中专门针对老年患者的信息进行分析后得出的部分结果。除了少数专门针对老年问题的指南外,所有分析的指南中均缺乏有关老年患者的信息。指南中很少有明确说明信息缺失原因的陈述。因此,指南使用者仍然不知道这是因为缺乏可用数据。从使用者的角度来看,应该有一个在线平台通过共享访问提供完整的证据。这显然会改善总体情况,从而便于查找特定问题,例如老年和多重疾病。此外,指南使用的实际方面还有改进空间,例如指南形式的标准化以及整合各个指南门户网站显然会帮助希望了解总体情况的人。此外,大多数指南在内容、参考文献、循证信息解释和建议之间没有内部链接,而这些对于有效研究是必要的。

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[Decisions of the Federal Joint Committee for rejecting work with "weak" or failing evidence].[联邦联合委员会关于拒绝采用“薄弱”或无效证据开展工作的决定]
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