From the San Antonio Military Health System, Brooke Army Medical Center, San Antonio, TX (Osborn), and Hennepin Healthcare, Minneapolis, MN (Schmidt).
J Am Acad Orthop Surg. 2021 Mar 1;29(5):183-188. doi: 10.5435/JAAOS-D-19-00858.
The Major Extremity Trauma and Rehabilitation Consortium and the American Academy of Orthopaedic Surgeons have developed the Appropriate Use Criteria (AUC) for the Diagnosis and Management of Acute Compartment Syndrome (ACS). Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care, aid decision-making, and obtain the best possible outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC for the Diagnosis and Management of ACS were derived by identifying clinical indications typical of patients suspected of an ACS in clinical practice. These indications were most often parameters observable by the clinician, including symptoms or results of diagnostic tests. The 135 patient scenarios and five treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a nine-point scale to designate a treatment as "appropriate" (median rating, seven to nine), "may be appropriate" (median rating, four to six), or "rarely appropriate" (median rating, one to three).
主要肢体创伤和康复联盟以及美国矫形外科医师学会已经制定了用于诊断和治疗急性间隔综合征(ACS)的适当使用标准(AUC)。这些标准是结合医生的临床专业知识和循证信息制定的,旨在改善患者护理、辅助决策,并在考虑临床决策所需的细微差别和区别的情况下获得最佳结果。ACS 的诊断和管理 AUC 是通过确定在临床实践中疑似 ACS 患者的典型临床指征来得出的。这些指征通常是临床医生可以观察到的参数,包括症状或诊断测试的结果。135 个患者情况和 5 种治疗方法是由写作小组开发的,该小组由在该 AUC 主题方面的专家组成。接下来,一个独立的多学科投票小组(由专家和非专家组成)使用九点量表对每个患者情况的治疗方法进行适当性评估,以将治疗方法指定为“适当”(中位数评分 7 到 9)、“可能适当”(中位数评分 4 到 6)或“很少适当”(中位数评分 1 到 3)。