Zheng H C, Li X T, Men P, Ma X, Wang Q, Chen Y L, Zhai S D
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China.
Department of Pharmacy Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18;52(4):715-718. doi: 10.19723/j.issn.1671-167X.2020.04.023.
To select and define the clinical questions and outcomes of .
A draft including clinical questions, which could be divided into foreground questions and background questions, and outcomes was drawn and revised by the secretary group for the guideline referring to the present guidelines with the guidance of a panel consisting of 7 experienced clinical medicine, pharmacy and nursing experts. Foreground questions and outcomes of the draft were voted into a final version after three rounds of counsels of 22 experienced medicine, pharmacy and nursing clinical experts using Delphi method including 3 rounds of inquiry. And the background questions were directly included in the guideline after the 22 experts' thorough revising. The research was carried out under the supervision of method ologists. Active coefficient, coefficient of variation and the frequencies of each score were calculated for quality control.
The draft of 34 foreground questions, 6 background questions and 6 outcomes was finally drawn up after thorough selecting and consulting. The 6 background questions revised by the clinical experts were all included. After three rounds of Delphi method, 28 pivotal clinical questions covering the diagnosis, preparation for the treatment, treatment and administration after the treatment, and 6 outcomes were defined and included for the guideline. The rest of the foreground questions, 4 of which were recognized as essential and 2 as important, were excluded from the guideline and left for further revising or updating. As for the outcomes, 4 of them were recognized as critical and the rest as important. The experts contributing to the research were active as the active coefficient reached 100%, and the degree of consensus was fine as the frequencies of the feedback scoring equal to or greater than 4 for all the 28 foreground questions included were greater than 75% and the result was settled in the first round. And 2 outcomes, fatality rate and severity, reached a higher degree of consensus with coefficient of variation less than 15%.
After thorough and rigorous selecting, the clinical questions and outcomes to be included in the were finally selected and defined Delphi method, guiding the future development of the guidelines.
筛选并确定……的临床问题和结局。
在由7位经验丰富的临床医学、药学和护理专家组成的小组指导下，秘书组参照现行指南起草了一份包含临床问题（可分为前景问题和背景问题）及结局的草案，并进行修订。草案中的前景问题和结局经22位经验丰富的医学、药学和护理临床专家采用德尔菲法进行三轮咨询（包括三轮询问）后投票形成最终版本。背景问题经22位专家全面修订后直接纳入指南。研究在方法学家的监督下进行。计算活性系数、变异系数和各评分频率以进行质量控制。
经过全面筛选和咨询，最终拟定了34个前景问题、6个背景问题和6个结局的草案。临床专家修订的6个背景问题均被纳入。经过三轮德尔菲法，确定并纳入指南的有28个关键临床问题，涵盖诊断、治疗准备、治疗后处理及给药，以及6个结局。其余前景问题中，4个被认为是必要的，2个被认为是重要的，被排除在指南之外留待进一步修订或更新。至于结局，4个被认为是关键的，其余的是重要的。参与研究的专家积极性高，活性系数达到100%，共识程度良好，所有28个纳入的前景问题反馈评分等于或大于4的频率均大于75%，且结果在第一轮就确定了。2个结局，即死亡率和严重程度，变异系数小于15%，达成了更高程度的共识。
经过全面严格的筛选，最终采用德尔菲法筛选并确定了纳入……的临床问题和结局，为指南的未来发展提供了指导。
