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波兰的指南改编:证据实施的第一步。

Guideline adaptation in Poland: first step in evidence implementation.

机构信息

Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Int J Evid Based Healthc. 2019 Jun;17 Suppl 1:S12-S14. doi: 10.1097/XEB.0000000000000196.

Abstract

BACKGROUND

According to the report published by the National Chamber of Physicians, currently the guideline development process in Poland is not coordinated and there is no document setting the standards for the process or methods of guideline production in Poland or institution assessing guideline quality on a regular basis. We postulated that adaptation of good-quality guidelines can improve the quality of the guidelines available and serve as a first step in translating evidence into practice by making physicians aware of the evidence.

AIMS

To discuss methodological challenges and lessons learned during the project lead by the National Chamber of Physicians regarding guideline adaptation in Poland as a first step in evidence implementation.

METHODS

The National Chamber of Physicians set up a project that involved adaptation of the guidelines with the use of a systematic approach suggested by the ADAPTE Collaboration. The guideline development team involved methodologist, clinical experts, specialists, primary care physician and patient representative. The process followed the framework established by the ADAPTE Toolkit.

RESULTS/DISCUSSION: The topic in one the groups was management of depression in primary care. Key lesson learned during the process of defining clinical questions included the importance of cooperation between all involved groups due to differences in their point of views. Since several guideline documents were identified, one of the important lessons learned during the development of inclusion and exclusion criteria was to define a minimal set of methodological inclusion criteria because the documents found varied in the methods used and in the thoroughness of the description of the process.

CONCLUSION

Well defined inclusion criteria, systematic use of available methods for the assessment of guideline quality and tools provided by the ADAPTE Toolkit refined to the needs of the guideline development groups facilitated the process of guideline adaptation in Poland as a first step in evidence implementation.

摘要

背景

根据国家医师协会发布的报告,目前波兰的指南制定过程缺乏协调,也没有文件为波兰的指南制定过程或方法设定标准,或定期评估指南质量。我们假设,采用高质量的指南可以提高指南的质量,并通过让医生了解证据,作为将证据转化为实践的第一步。

目的

讨论国家医师协会领导的关于波兰指南适应的项目中的方法学挑战和经验教训,作为证据实施的第一步。

方法

国家医师协会设立了一个项目,该项目使用 ADAPTE 合作提出的系统方法来改编指南。指南制定团队由方法学家、临床专家、专家、初级保健医生和患者代表组成。该过程遵循 ADAPTE 工具包建立的框架。

结果/讨论:一个小组的主题是初级保健中的抑郁症管理。在定义临床问题的过程中,重要的经验教训包括由于不同观点的合作的重要性。由于确定了几个指南文件,在制定纳入和排除标准的过程中,重要的经验教训之一是定义一组最小的方法学纳入标准,因为发现的文件在使用的方法和对过程的描述的彻底性方面存在差异。

结论

明确的纳入标准、系统地使用可用的指南质量评估方法和 ADAPTE 工具包提供的工具,并根据指南制定小组的需求进行调整,有助于波兰指南适应作为证据实施的第一步的过程。

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