Otolaryngology, Emory University, USA.
Otolaryngology, Johns Hopkins University, USA.
Int Forum Allergy Rhinol. 2018 Feb;8(2):108-352. doi: 10.1002/alr.22073.
Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR).
Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus.
The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR.
This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.
为了提高对变应性鼻炎(AR)的认识,并将这些知识恰当地应用于 AR 患者的临床护理,有必要对现有的 AR 文献进行质量和有效性的严格评估。为了评估现有的 AR 文献,国际多学科专家对 AR 进行了研究,制定了过敏和鼻科学国际共识声明:变应性鼻炎(ICAR:AR)。
采用先前描述的方法,制定了与 AR 相关的特定主题。根据可用证据和 ICAR:AR 文件中的目的,为每个主题分配了文献综述、基于证据的综述(EBR)或基于证据的综述和建议(EBRR)格式。在对每个主题进行迭代审查后,综合 ICAR:AR 文件,并由所有作者对共识进行审查。
ICAR:AR 文件涉及与 AR 相关的 100 多个单独主题,包括诊断、病理生理学、流行病学、疾病负担、AR 发展的危险因素、过敏测试方式、治疗以及与 AR 相关的其他疾病/合并症。
对 AR 文献的严格审查确定了一些优势;可以相信,治疗决策得到了严格研究的支持。然而,AR 文献中也存在很大的差距。这些知识差距应被视为改进的机会,因为我们所教授的内容和所实践的医学往往不是基于最佳质量的证据。本文旨在强调 AR 文献的优缺点,以确定未来 AR 研究和更好理解的领域。