Aertgeerts Bert, Agoritsas Thomas, Siemieniuk Reed A C, Burgers Jako, Bekkering Geertruida E, Merglen Arnaud, van Driel Mieke, Vermandere Mieke, Bullens Dominique, Okwen Patrick Mbah, Niño Ricardo, van den Bruel Ann, Lytvyn Lyubov, Berg-Nelson Carla, Chua Shunjie, Leahy Jack, Raven Jennifer, Weinberg Michael, Sadeghirad Behnam, Vandvik Per O, Brignardello-Petersen Romina
Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium
CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium.
BMJ. 2017 Sep 20;358:j4090. doi: 10.1136/bmj.j4090.
What is the role of a single dose of oral corticosteroids for those with acute sore throat? Using the GRADE framework according to the BMJ Rapid Recommendation process, an expert panel make a weak recommendation in favour of corticosteroid use. The panel produced these recommendations based on a linked systematic review triggered by a large randomised trial published in April 2017. This trial reported that corticosteroids increased the proportion of patients with complete resolution of pain at 48 hours. Box 1 shows all of the articles and evidence linked in this Rapid Recommendation package. The infographic provides the recommendation together with an overview of the absolute benefits and harms of corticosteroids in the standard GRADE format. Table 2 below shows any evidence that has emerged since the publication of this article. Clinicians and their patients can find consultation decision aids to facilitate shared decision making in MAGICapp (www.magicapp.org/goto/guideline/JjXYAL/section/j79pvn).
对于急性咽痛患者,单次口服皮质类固醇激素有何作用?根据《英国医学杂志》快速推荐流程,采用GRADE框架,一个专家小组做出了一项支持使用皮质类固醇激素的弱推荐。该小组基于2017年4月发表的一项大型随机试验引发的相关系统评价得出这些推荐。该试验报告称,皮质类固醇激素增加了48小时时疼痛完全缓解的患者比例。方框1展示了此快速推荐包中所有相关的文章和证据。信息图以标准的GRADE格式提供了该推荐以及皮质类固醇激素绝对益处和危害的概述。下表2显示了自本文发表以来出现的任何证据。临床医生及其患者可在MAGICapp(www.magicapp.org/goto/guideline/JjXYAL/section/j79pvn)中找到咨询决策辅助工具,以促进共同决策。