Centre of Evidence-Based Dermatology, University of Nottingham, King's Meadow Campus, Lenton Lane, Nottingham, UK.
Br J Dermatol. 2013 Mar;168(3):577-82. doi: 10.1111/bjd.12040. Epub 2013 Jan 18.
Eczema is a common condition, yet there are uncertainties regarding many frequently used treatments. Knowing which of these uncertainties matter to patients and clinicians is important, because they are likely to have different priorities from those of researchers and funders.
To identify the uncertainties in eczema treatment that are important to patients who have eczema, their carers and the healthcare professionals (HCPs) who treat them.
An eczema Priority Setting Partnership was established, including patients, HCPs and researchers. Eczema treatment uncertainties were gathered from patients and clinicians, and then prioritized in a transparent process, using a methodology advocated by the James Lind Alliance.
In the consultation stage 493 participants (including 341 patients/carers) made 1070 submissions, of which 718 were uncertainties relating to the treatment of eczema. Treatment uncertainties with more than one submission were grouped into 52 'indicative uncertainties', which were then ranked by 514 participants (including 399 patients/carers). The top 14 treatment uncertainties were prioritized for research. The first four were common to patients/carers and HCPs (shared uncertainties): (i) the best and safest way of using topical steroids (including frequency of application, potency, length of time, alternation with other topical treatments and age limits); (ii) the long-term safety of topical steroids; (iii) the role of food allergy tests; and (iv) the most effective and safe emollients in treating eczema. The remaining 10 of the top 14 uncertainties comprised the next five highest ranked uncertainties for patients and the next five highest ranked uncertainties for HCPs. At a workshop involving 40 participants (patients, HCPs and researchers), shared uncertainties were formulated into possible research questions.
The top 14 treatment uncertainties around the treatment of eczema provide guidance for researchers and funding bodies to ensure that future research answers questions that are important to both clinicians and patients.
湿疹是一种常见病症，但许多常用治疗方法仍存在不确定性。了解这些不确定性对湿疹患者、照护者以及治疗他们的医疗保健专业人员（HCP）而言至关重要，因为他们的优先事项可能与研究人员和资助者不同。
确定湿疹治疗中对湿疹患者、照护者以及治疗他们的 HCP 重要的不确定性。
建立了湿疹优先事项设定伙伴关系，包括患者、HCP 和研究人员。从患者和临床医生那里收集了湿疹治疗不确定性，并使用詹姆斯林德联盟（James Lind Alliance）提倡的方法在透明流程中对其进行优先排序。
在咨询阶段，493 名参与者（包括 341 名患者/照护者）提出了 1070 项意见，其中 718 项与湿疹治疗有关。有多项意见的治疗不确定性被分为 52 个“指示性不确定性”，然后由 514 名参与者（包括 399 名患者/照护者）进行排名。排名前 14 位的治疗不确定性被列为研究重点。前四项是患者/照护者和 HCP 共有的（共同不确定性）：（i）外用皮质类固醇的最佳和最安全使用方法（包括应用频率、效力、使用时间、与其他外用治疗交替使用以及年龄限制）；（ii）外用皮质类固醇的长期安全性；（iii）食物过敏测试的作用；以及（iv）治疗湿疹最有效和最安全的保湿剂。排名前 14 位的其余 10 项不确定性包括患者排名第五高的不确定性和 HCP 排名第五高的不确定性。在涉及 40 名参与者（患者、HCP 和研究人员）的研讨会上，共同不确定性被制定成可能的研究问题。
治疗湿疹的前 14 项治疗不确定性为研究人员和资助机构提供了指导，以确保未来的研究能够回答对临床医生和患者都重要的问题。
