咳嗽管理的制定方法:CHEST 指南和专家小组报告。
Methodologies for the development of the management of cough: CHEST guideline and expert panel report.
机构信息
From the CHEST, Glenview, IL.
From the CHEST, Glenview, IL.
出版信息
Chest. 2014 Nov;146(5):1395-1402. doi: 10.1378/chest.14-1484.
BACKGROUND
This series of guidance documents on cough, which will be published over time, is a hybrid of two processes: (1) evidence-based guidelines and (2) trustworthy consensus statements based on a robust and transparent process.
METHODS
The CHEST Guidelines Oversight Committee selected a nonconflicted Panel Chair and jointly assembled an international panel of experts in each clinical area with few, if any, conflicts of interest. PICO (population, intervention, comparator, outcome)-based key questions and parameters of eligibility were developed for each clinical topic to inform the comprehensive literature search. Existing guidelines, systematic reviews, and primary studies were assessed for relevance and quality. Data elements were extracted into evidence tables and synthesized to provide summary statistics. These, in turn, are presented to support the evidence-based graded recommendations. A highly structured consensus-based Delphi approach was used to provide expert advice on all guidance statements. Transparency of process was documented.
RESULTS
Evidence-based guideline recommendations and consensus-based suggestions were carefully crafted to provide direction to health-care providers and investigators who treat and/or study patients with cough. Manuscripts and tables summarize the evidence in each clinical area supporting the recommendations and suggestions.
CONCLUSIONS
The resulting guidance statements are based on a rigorous methodology and transparency of process. Unless otherwise stated, the recommendations and suggestions meet the guidelines for trustworthiness developed by the Institute of Medicine and can be applied with confidence by physicians, nurses, other health-care providers, investigators, and patients.
背景
本系列关于咳嗽的指南文件将陆续出版,是两种过程的结合:(1)基于证据的指南,(2)基于稳健透明流程的可信共识声明。
方法
CHEST 指南监督委员会挑选了一位无利益冲突的组长,并共同组建了每个临床领域的国际专家小组,他们的利益冲突很少或没有。为每个临床主题制定了基于 PICO(人群、干预、对照、结局)的关键问题和资格参数,以告知全面的文献检索。评估了现有指南、系统评价和原始研究的相关性和质量。将数据元素提取到证据表中并进行综合,以提供汇总统计数据。这些数据反过来又用于支持基于证据的分级推荐。采用高度结构化的基于共识的 Delphi 方法就所有指南声明提供专家建议。记录了流程的透明度。
结果
精心制定了基于证据的指南推荐和基于共识的建议,为治疗和/或研究咳嗽患者的医疗保健提供者和研究人员提供指导。手稿和表格总结了每个临床领域支持推荐和建议的证据。
结论
得出的指导意见是基于严格的方法和流程的透明度。除非另有说明,否则建议和建议符合医学研究所制定的可信度准则,可以由医生、护士、其他医疗保健提供者、研究人员和患者有信心地应用。