Pinnock Hilary, Østrem Anders, Rodriguez Miguel Román, Ryan Dermot, Ställberg Björn, Thomas Mike, Tsiligianni Ioanna, Williams Sian, Yusuf Osman
Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
Prim Care Respir J. 2012 Mar;21(1):19-27. doi: 10.4104/pcrj.2012.00006.
Community-based care, underpinned by relevant primary care research, is an important component of the global fight against non-communicable diseases. The International Primary Care Research Group's (IPCRG's) Research Needs Statement identified 145 research questions within five domains (asthma, rhinitis, chronic obstructive pulmonary disease (COPD), smoking, respiratory infections).
To use an e-mail Delphi process to prioritise the research questions.
An international panel of primary care clinicians scored the clinical importance, feasibility, and international relevance of each question on a scale of 1-5 (5 = most important). In subsequent rounds, informed by the Group's median scores, participants scored overall priority. Consensus was defined as 80% agreement for priority scores 4 or 5.
Twenty-three experts from 21 countries completed all three rounds. Sixty-two questions were prioritised across the five domains. A recurring theme was for 'simple tools' (e.g. questionnaires) enabling diagnosis and assessment in community settings, often with limited access to investigations. Seven questions recorded 100% agreement: these involved pragmatic approaches to the diagnosis of COPD and rhinitis, assessment of asthma and respiratory infections, management of rhinitis, and implementing asthma self-management.
Evidence to underpin the primary care approach to diagnosis and assessment and broad management strategies were overarching priorities. If primary care is to contribute to the global challenge of managing respiratory non-communicable diseases, policymakers, funders, and researchers need to prioritise these questions.
基于社区的护理，以相关的初级保健研究为支撑，是全球抗击非传染性疾病的重要组成部分。国际初级保健研究小组（IPCRG）的研究需求声明在五个领域（哮喘、鼻炎、慢性阻塞性肺疾病（COPD）、吸烟、呼吸道感染）确定了145个研究问题。
采用电子邮件德尔菲法对研究问题进行优先级排序。
一个由初级保健临床医生组成的国际小组对每个问题的临床重要性、可行性和国际相关性进行评分，范围为1至5分（5分 = 最重要）。在随后的轮次中，参与者根据该小组的中位数分数对总体优先级进行评分。共识定义为对于优先级分数4或5达成80%的一致意见。
来自21个国家的23名专家完成了所有三轮评估。在五个领域中确定了62个优先问题。一个反复出现的主题是“简单工具”（如问卷），用于在社区环境中进行诊断和评估，而社区环境往往难以获得检查资源。有七个问题获得了100%的一致意见：这些问题涉及COPD和鼻炎诊断的实用方法、哮喘和呼吸道感染的评估、鼻炎的管理以及实施哮喘自我管理。
为初级保健诊断、评估方法及广泛管理策略提供依据的证据是首要优先事项。如果初级保健要为应对管理呼吸道非传染性疾病的全球挑战做出贡献，政策制定者、资助者和研究人员需要优先考虑这些问题。
