Department of Urology, Erasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, Netherlands.
University of California, San Francisco, 550 16th Street, Department of Urology, 6th Floor, Mailbox Code 1695, San Francisco, California 94143, USA.
Nat Rev Urol. 2017 May;14(5):312-322. doi: 10.1038/nrurol.2017.26. Epub 2017 Mar 14.
Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if ≥70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.
主动监测(AS)通常被描述为低危前列腺癌患者的一种管理选择,但文献和指南中存在语义上的异质性。为了解决这个问题,一组在 AS 领域的领先前列腺癌专家使用改良 Delphi 方法参与了一项共识形成项目,就与这种管理选择相关的术语定义达成国际共识。每位小组成员都完成了三轮在线问卷的迭代,共 61 个单项。如果≥70%的专家同意一个定义,则认为达成了共识。为了促进所有参与专家之间的共同理解并解决潜在的歧义,在 Delphi 调查两轮和三轮之间举行了一次面对面的共识会议。方便抽样用于构建专家小组。共有来自澳大利亚、法国、芬兰、意大利、荷兰、日本、英国、加拿大和美国的 12 名专家参加。在 Delphi 过程结束时,100%(n=61)的术语达成了正式共识,随后开发了一个词汇表。国际专家就局部前列腺癌患者的 AS 相关术语和后续定义达成了一致。这种标准术语可以支持多学科交流,减少临床实践中的差异程度,并优化临床决策。