Heggeness Michael H, Sanders James O, Murray Jayson, Pezold Ryan, Sevarino Kaitlyn S
J Am Acad Orthop Surg. 2015 Oct;23(10):e49-51. doi: 10.5435/JAAOS-D-15-00406. Epub 2015 Aug 28.
The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) on the Management of Pediatric Supracondylar Humerus Fractures (PSHF). Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The PSHF AUC clinical patient scenarios were derived from patient indications that generally accompany a PSHF as well as from current evidence-based clinical practice guidelines and supporting literature. The 220 patient scenarios and 14 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Next, the Review Panel, a separate group of volunteer physicians, independently reviewed these materials to ensure that they were representative of patient scenarios that clinicians are likely to encounter in daily practice. Finally, the multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
美国骨科医师学会制定了小儿肱骨髁上骨折（PSHF）管理的合理使用标准（AUC）。基于证据的信息与医生的临床专业知识相结合，用于制定这些标准，以改善患者护理并在考虑临床决策所需的细微差别和区别的同时获得最佳结果。PSHF AUC临床患者场景源自通常伴随PSHF出现的患者指征以及当前基于证据的临床实践指南和支持文献。这220个患者场景和14种治疗方法由写作小组制定，该小组是一群在此AUC主题方面的临床专家。接下来，评审小组（另一组志愿医生）独立审查了这些材料，以确保它们代表临床医生在日常实践中可能遇到的患者场景。最后，多学科投票小组（由专家和非专家组成）使用9分制对每个患者场景的治疗适宜性进行评分，将治疗指定为适宜（中位数评分，7至9）、可能适宜（中位数评分，4至6）或很少适宜（中位数评分，1至3）。
