Proc Am Thorac Soc. 2012 Dec;9(5):215-8. doi: 10.1513/pats.201208-053ST.
Organizations around the world are recognizing that guidelines should be based on the best available evidence, that the development of recommendations needs to be transparent, and that appropriate processes should be followed. In June 2007, we convened an American Thoracic Society (ATS)/European Respiratory Society (ERS)-sponsored workshop with over 60 representatives from 36 international organizations to provide advice to guideline developers about the required steps and processes for guideline development using the management of chronic obstructive pulmonary disease (COPD) as an example. Following the workshop, participants completed a series of 14 review articles that underwent peer review and incorporated key new literature until June 2011 for most articles in this series. The review articles evaluate the guideline cycle including: priority setting, question formulation, managing conflict of interest, defining appropriate outcomes, stakeholder involvement, grading the quality of evidence and strength of recommendations, integration of values and preferences, considering resource use, reporting of guidelines, implementation, and adaptation. In this Introduction we frame the background and methods of these reviews and provide the key conclusions of the workshop. A summary of the workshop's conclusions and recommendations was published in The Lancet. Given the enormous resources that are spent on research and the importance of providing the best guidance to healthcare decision makers, attributing appropriate funds to research syntheses and transparent, independent guidance for the development of evidence-based guidelines is justified. Furthermore, given the immense amount of work that is required, individuals and organizations need to collaborate to achieve the best possible and cost-effective coordination of these efforts.
世界各地的组织都认识到,指南应该基于最佳现有证据,建议的制定需要透明,并且应该遵循适当的流程。2007 年 6 月,我们召开了一次由美国胸科学会(ATS)/欧洲呼吸学会(ERS)主办的研讨会,来自 36 个国际组织的 60 多名代表参加了会议,为指南制定者提供了有关使用慢性阻塞性肺疾病(COPD)管理作为示例制定指南所需步骤和流程的建议。研讨会结束后,参与者完成了一系列 14 篇综述文章,这些文章经过同行评审,并纳入了关键的新文献,直到 2011 年 6 月,本系列中的大多数文章都进行了修订。这些综述文章评估了指南周期,包括:重点设定、问题制定、管理利益冲突、定义适当的结果、利益相关者参与、评估证据质量和建议强度、整合价值观和偏好、考虑资源利用、报告指南、实施和适应。在本引言中,我们阐述了这些综述的背景和方法,并提供了研讨会的主要结论。研讨会的结论和建议摘要发表在《柳叶刀》上。鉴于在研究上投入了大量资源,以及为医疗保健决策者提供最佳指导的重要性,将适当的资金用于研究综合评估以及透明、独立的循证指南制定是合理的。此外,鉴于需要完成的大量工作,个人和组织需要合作,以实现这些努力的最佳和最具成本效益的协调。