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骨质疏松症的诊断、治疗和随访——拉丁美洲内分泌学会立场声明

Diagnostic, treatment, and follow-up of osteoporosis-position statement of the Latin American Federation of Endocrinology.

机构信息

Departamento de Ciencias Fisiológicas, Facultad de Medicina de la Pontificia, Universidad Javeriana, Bogotá, Colombia.

Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE), Bogotá, Colombia.

出版信息

Arch Osteoporos. 2021 Jul 24;16(1):114. doi: 10.1007/s11657-021-00974-x.

Abstract

UNLABELLED

The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region.

INTRODUCTION

There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap.

METHODS

An experts' panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions.

RESULTS

Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems.

CONCLUSIONS

Through a process based on recognized methodological tools, FELAEN's position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.

摘要

目的

本研究旨在阐述拉丁美洲内分泌学会(FELAEN)关于绝经后女性骨质疏松症管理的立场,以更好地弥合这一差距。

方法

成立了一个由来自 9 个国家的 11 名内分泌学家组成的专家小组。采用概念方法进行了数据检索,并根据循证医学金字塔的层次结构对数据进行了选择。为了确定医疗保健障碍,考虑了未发表的数据和当地流行病学数据以及专家意见。采用德尔菲法进行专家共识。专家们被要求对指导问题的两个答案在 5 分李克特量表上进行回答。

结果

对于李克特量表中位数较高的问题,专家们达成了共识,并综合了 16 个声明,涵盖了骨质疏松症的定义、诊断方法、治疗选择和随访。除了临床问题外,还根据当地流行病学数据、治疗障碍和卫生系统内项目的分类不当,确定了骨质疏松症方面的未满足需求。

结论

通过基于公认的方法学工具的过程,制定了 FELAEN 关于骨质疏松症的立场。这使得为疾病的治疗制定最佳方案成为可能,并有助于确定知识差距。拉丁美洲在处理骨质疏松症方面存在很大差异,而且在医疗保健的各个阶段仍然存在障碍。

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