School Of Medicine, Physical Medicine Rehabilitation, Akdeniz University, Antalya, Turkey.
Antalya Training and Research Hospital, Physical Medicine Rehabilitation and Rheumatology, University of Health Sciences, Antalya, Turkey.
Rheumatol Int. 2018 Aug;38(8):1315-1331. doi: 10.1007/s00296-018-4044-y. Epub 2018 May 17.
In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.
在 2012 年，土耳其抗风湿联盟（TLAR）首次在我国制定了膝关节骨关节炎（OA）的循证管理推荐意见（TLAR-2012）。随着医学知识和科学证据的不断发展，推荐意见也进行了更新。该委员会由 22 名物理医学与康复专家（其中 4 名具有风湿病专业）和 1 名骨科医生组成。在 2012 年 1 月 1 日至 2015 年 1 月 29 日期间，在 PubMed、Embase、Cochrane 和土耳其医学索引上进行了系统的文献检索。对文献进行了质量评估，并根据证据水平进行了分类，选择的文献通过电子邮件发送给委员会成员。要求他们制定新的建议。在 2015 年的会议上，决定根据疾病的严重程度和患者的具体情况，采用以患者为中心的推荐格式。根据新证据，对每个项目进行讨论，制定最终的推荐意见。每个项目都在 10 厘米的视觉模拟量表（VAS）上进行电子投票，并计算推荐强度（SoR）。根据证据，共制定了 11 项推荐意见；前 7 项适用于疾病各个阶段的每位患者，其余的则适用于特定的临床情况。推荐意见的平均 SoR 值在 7.44 到 9.93 之间。TLAR-2012 推荐意见采用了新的格式进行了更新。我们认为，这些新的推荐意见将对管理该疾病的医生和患者都有帮助。
