Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Australas J Dermatol. 2020 Feb;61(1):23-32. doi: 10.1111/ajd.13124. Epub 2019 Aug 1.
BACKGROUND/OBJECTIVES: Atopic dermatitis (AD) has significant negative impact on health-related quality of life, mood, sleep, work productivity and everyday activities. Research into the use of new drugs in the management of AD continues to develop, and international updates and recommendations have been published. However, questions remain in the Australian setting. This consensus aims to provide evidence-based insights and practical advice on the management of adult AD in Australia.
A panel (five dermatologists and one clinical immunologist) met to review the literature, critically examine clinical questions of relevance to Australian healthcare practitioners and develop a series of recommendation statements. A consensus panel, comprising the initial panel plus nine additional members, used a 2-round Delphi voting process to determine a set of final guidance statements.
≥75% agreement in the range 7-9.
Round 1 voting comprised 66 guidance statements. Of these, consensus was reached on 26, which were retained, and five were removed. The remainder (35) were modified and one new guidance statement was added for inclusion in round 2 voting. After round 2, consensus was reached on 35, which were retained, and one was removed (considered redundant). The 61 guidance statements upon which consensus was reached were then used to support a series of core consensus recommendations and a management flow chart.
Expert consensus recommendations providing practical guidance of clinical relevance to specialists and primary care physicians in Australia have been developed. Dissemination of this guidance and evaluation of its impact on patient outcomes remain to be undertaken.
背景/目的：特应性皮炎（AD）对健康相关生活质量、情绪、睡眠、工作效率和日常活动有重大负面影响。关于管理 AD 的新药的研究不断发展，国际上也发布了更新和建议。然而，在澳大利亚环境下仍存在疑问。本共识旨在提供基于证据的见解和实用建议，以管理澳大利亚的成人 AD。
一个小组（五名皮肤科医生和一名临床免疫学家）开会审查文献，仔细审查与澳大利亚医疗保健从业者相关的临床问题，并制定一系列建议陈述。一个共识小组，由最初的小组加上另外九名成员组成，使用两轮 Delphi 投票过程来确定一组最终的指导陈述。
范围在 7-9 之间的 75%以上的一致性。
第一轮投票包括 66 条指导意见。其中，有 26 条达成共识，保留下来，5 条被删除。其余 35 条经过修改，并增加了一条新的指导意见，以供第二轮投票。第二轮投票后，有 35 条达成共识，保留下来，1 条被删除（被认为是多余的）。达成共识的 61 条指导意见随后被用于支持一系列核心共识建议和管理流程图。
已经制定了针对澳大利亚专家和初级保健医生具有临床相关性的实用指导的专家共识建议。需要进一步传播这一指导意见，并评估其对患者结局的影响。
