Hart Ailsa L, Lomer Miranda, Verjee Azmina, Kemp Karen, Faiz Omar, Daly Ann, Solomon Julie, McLaughlin John
IBD Unit, St Mark's Hospital, Harrow, Middlesex, UK
Diabetes & Nutritional Sciences Division, Kings College London, London, UK.
J Crohns Colitis. 2017 Feb;11(2):204-211. doi: 10.1093/ecco-jcc/jjw144. Epub 2016 Aug 9.
Many uncertainties remain regarding optimal therapies and strategies for the treatment of inflammatory bowel disease. Setting research priorities addressing therapies requires a partnership between health care professionals, patients and organisations supporting patients. We aimed to use the structure of the James Lind Alliance Priority Setting Partnership, which has been used in other disease areas, to identify and prioritise unanswered questions about treatments for inflammatory bowel disease.
The James Lind Priority Setting Partnership uses methods agreed and adopted in other disease areas to work with patients and clinicians: to identify uncertainties about treatments; to agree by consensus a prioritised list of uncertainties for research; then to translate these uncertainties into research questions which are amenable to hypothesis testing; and finally to take results to research commissioning bodies to be considered for funding.
A total of 1636 uncertainties were collected in the initial survey from 531 respondents, which included 22% health care professionals and 78% patients and carers. Using the rigorously applied processes of the priority setting partnership, this list was distilled down to the top 10 research priorities for inflammatory bowel disease. The top priorities were: identifying treatment strategies to optimise efficacy, safety and cost-effectiveness; and stratifying patients with regard to their disease course and treatment response. Diet and symptom control [pain, incontinence and fatigue] were also topics which were prioritised.
A partnership involving multidisciplinary clinicians, patients and organisations supporting patients has identified the top 10 research priorities in the treatment of patients with inflammatory bowel disease.
关于炎症性肠病的最佳治疗方法和策略仍存在许多不确定性。确定治疗方面的研究重点需要医疗保健专业人员、患者以及支持患者的组织之间建立合作关系。我们旨在利用詹姆斯·林德联盟优先事项设定合作组织(James Lind Alliance Priority Setting Partnership)的架构(该架构已在其他疾病领域使用)来识别和确定关于炎症性肠病治疗的未解决问题的优先级。
詹姆斯·林德优先事项设定合作组织采用在其他疾病领域商定并采用的方法,与患者和临床医生合作:识别治疗方面的不确定性;通过共识商定一份研究不确定性的优先列表;然后将这些不确定性转化为适合进行假设检验的研究问题;最后将结果提交给研究委托机构以供考虑资助。
在初始调查中,531名受访者共收集到1636个不确定性问题,其中包括22%的医疗保健专业人员以及78%的患者和护理人员。通过严格应用优先事项设定合作组织的流程,该列表被提炼为炎症性肠病的前10大研究重点。首要重点是:确定优化疗效、安全性和成本效益的治疗策略;以及根据疾病进程和治疗反应对患者进行分层。饮食和症状控制(疼痛、大小便失禁和疲劳)也是被列为优先事项的主题。
一个由多学科临床医生、患者以及支持患者的组织参与的合作组织确定了炎症性肠病治疗的前10大研究重点。