Sussman Jon, Farrugia Maria E, Maddison Paul, Hill Marguerite, Leite M Isabel, Hilton-Jones David
Department of Neurology, Greater Manchester Neuroscience Centre, Salford, Greater Manchester, UK.
Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
Pract Neurol. 2015 Jun;15(3):199-206. doi: 10.1136/practneurol-2015-001126.
Myasthenia gravis is an autoimmune disease of the neuromuscular junction for which many therapies were developed before the era of evidence based medicine. The basic principles of treatment are well known, however, patients continue to receive suboptimal treatment as a result of which a myasthenia gravis guidelines group was established under the aegis of The Association of British Neurologists. These guidelines attempt to steer a path between evidence-based practice where available, and established best practice where evidence is unavailable. Where there is insufficient evidence or a choice of options, the guidelines invite the clinician to seek the opinion of a myasthenia expert. The guidelines support clinicians not just in using the right treatments in the right order, but in optimising the use of well-known therapeutic agents. Clinical practice can be audited against these guidelines.
重症肌无力是一种神经肌肉接头处的自身免疫性疾病,在循证医学时代之前就已开发出多种治疗方法。治疗的基本原则是众所周知的,然而,患者仍在接受次优治疗,因此在英国神经学家协会的支持下成立了一个重症肌无力指南小组。这些指南试图在有可用循证实践和无证据时的既定最佳实践之间找到一条路径。在证据不足或有多种选择的情况下,指南邀请临床医生征求重症肌无力专家的意见。这些指南不仅支持临床医生以正确的顺序使用正确的治疗方法,还支持优化使用知名治疗药物。临床实践可以对照这些指南进行审核。