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编辑精选 - 急性肢体缺血血运重建注册数据采集建议:国际血管登记研究联合会的德尔菲共识。

Editor's Choice - Recommendations for Registry Data Collection for Revascularisations of Acute Limb Ischaemia: A Delphi Consensus from the International Consortium of Vascular Registries.

机构信息

Department of Vascular Medicine, University Heart Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

出版信息

Eur J Vasc Endovasc Surg. 2019 Jun;57(6):816-821. doi: 10.1016/j.ejvs.2019.02.023. Epub 2019 May 22.

Abstract

OBJECTIVE

To develop a minimum core data set for evaluation of acute limb ischaemia (ALI) revascularisation treatment and outcomes that would enable collaboration among international registries.

METHODS

A modified Delphi approach was used to achieve consensus among international multidisciplinary vascular specialists and registry members of the International Consortium of Vascular Registries (ICVR). Variables identified in the literature or suggested by the expert panel, and variables, including definitions, currently used in 15 countries in the ICVR, were assessed to define both a minimum core and an optimum data set to register ALI treatment. Clinical relevance and practicability were both assessed, and consensus was defined as ≥ 80% agreement among participants.

RESULTS

Of 40 invited experts, 37 completed a preliminary survey and 31 completed the two subsequent Delphi rounds via internet exchange and face to face discussions. In total, 117 different items were generated from the various registry data forms, an extensive review of the literature, and additional suggestions from the experts, for potential inclusion in the data set. Ultimately, 35 items were recommended for inclusion in the minimum core data set, including 23 core items important for all registries, and an additional 12 more specific items for registries capable of capturing more detail. These 35 items supplement previous data elements recommended for registering chronic peripheral arterial occlusive disease treatment.

CONCLUSION

A modified Delphi study allowed 37 international vascular registry experts to achieve a consensus recommendation for a minimum core and an optimum data set for registries covering patients who undergo ALI revascularisation. Continued global harmonisation of registry infrastructure and definition of items allows international comparisons and global quality improvement. Furthermore, it can help to define and monitor standards of care and enable international research collaboration.

摘要

目的

制定一个用于评估急性肢体缺血(ALI)血运重建治疗和结局的最小核心数据集,以便使国际登记处能够开展合作。

方法

采用改良 Delphi 法,让国际多学科血管专家和国际血管登记处联合会(ICVR)登记处成员达成共识。对文献中确定的变量或专家小组建议的变量,以及 ICVR 中 15 个国家目前使用的变量,包括定义进行评估,以确定登记 ALI 治疗的最小核心和最佳数据集。同时评估临床相关性和实用性,参与者的共识定义为≥80%的人同意。

结果

在 40 名受邀专家中,37 名专家完成了初步调查,31 名专家通过互联网交流和面对面讨论完成了随后的两轮 Delphi 调查。总共有 117 个不同的项目是从各种登记处数据表格、广泛的文献综述以及专家的其他建议中产生的,这些项目都有可能被纳入数据集。最终,推荐了 35 个项目纳入最小核心数据集,包括 23 个对所有登记处都很重要的核心项目,以及 12 个更具体的项目,供能够更详细地捕捉数据的登记处使用。这 35 个项目补充了之前推荐用于登记慢性外周动脉闭塞性疾病治疗的数据元素。

结论

改良 Delphi 研究使 37 名国际血管登记处专家就涵盖接受 ALI 血运重建的患者的登记处的最小核心和最佳数据集达成了共识建议。继续对登记处基础设施和项目定义进行全球协调,允许进行国际比较和全球质量改进。此外,它有助于定义和监测护理标准,并能够开展国际研究合作。

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