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[姑息医学中症状控制治疗建议的方法与制定]

[Methods and development of therapy recommendations for symptom control in palliative medicine].

作者信息

Radbruch L, Alt-Epping B, Rolke R, Ujeyl M, Nauck F

机构信息

Klinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.

出版信息

Schmerz. 2012 Sep;26(5):475-80. doi: 10.1007/s00482-012-1219-4.

Abstract

The Drug Commission of the German Medical Association has decided to develop treatment guidelines for palliative care. A series of systematic reviews was commissioned to evaluate the evidence for interventions of common symptoms that burden patients and care givers. A common methodology for all reviews is described in this paper. The methodology was based on the work of the European Palliative Care Research Collaborative. Standardized search strategies were identified in PubMed and Embase and these templates were then adapted by the authors of the reviews according to their needs. The template included the target group (patients and disease entities), indications (symptoms) and interventions (medicines and classes of medicines). Target groups included search terms on palliative or hospice care, cancer, neurodegenerative diseases, HIV/AIDS as well as cardiac and pulmonary failure. The number of relevant hits was surveyed in the first 40 hits in some exemplary searches. This was used for fine tuning the search templates and to optimize the search strategy in order to achieve the highest possible yield with the minimum possible effort. The review series was performed using this search strategy. Every review graded the quality of the included evidence following categories of the Drug Commission of the German Medical Association. Based on these results and recommendations the treatment guidelines will be formulated which will offer concise and evidence-based guidelines for general palliative medicine, offering primary care givers guidance for adequate palliative care in severely ill and dying patients. The English full text version of this article will be available in SpringerLink as of November 2012 (under "Supplemental").

摘要

德国医学协会药物委员会已决定制定姑息治疗的治疗指南。委托进行了一系列系统评价,以评估困扰患者和护理人员的常见症状干预措施的证据。本文描述了所有评价的通用方法。该方法基于欧洲姑息治疗研究协作组的工作。在PubMed和Embase中确定了标准化的检索策略,然后评价作者根据自身需求对这些模板进行了调整。模板包括目标人群(患者和疾病实体)、适应证(症状)和干预措施(药物和药物类别)。目标人群包括姑息或临终关怀、癌症、神经退行性疾病、艾滋病毒/艾滋病以及心脏和呼吸衰竭方面的检索词。在一些示例性检索中,对前40条命中结果中的相关命中数进行了统计。这用于微调检索模板并优化检索策略,以便以最小的努力获得尽可能高的产出。使用该检索策略进行了该系列评价。每项评价根据德国医学协会药物委员会的类别对纳入证据的质量进行了分级。基于这些结果和建议将制定治疗指南,为一般姑息医学提供简明且基于证据的指南,为初级护理人员在重症和临终患者的适当姑息治疗方面提供指导。本文的英文全文版本将于2012年11月在SpringerLink上提供(在“补充材料”下)。

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