加拿大脊髓损伤最佳实践指南（Can-SCIP）的制定：方法与概述。
Development of the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline: Methods and overview.
机构信息
KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.
Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Spinal Cord Med. 2021;44(sup1):S52-S68. doi: 10.1080/10790268.2021.1953312.
INTRODUCTION
Spinal cord injury (SCI) is a life-altering injury that leads to a complex constellation of changes in an individual's sensory, motor, and autonomic function which is largely determined by the level and severity of cord impairment. Available SCI-specific clinical practice guidelines (CPG) address specific impairments, health conditions or a segment of the care continuum, however, fail to address all the important clinical questions arising throughout an individual's care journey. To address this gap, an interprofessional panel of experts in SCI convened to develop the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline. This article provides an overview of the methods underpinning the Can-SCIP Guideline process.
METHODS
The Can-SCIP Guideline was developed using the Guidelines Adaptation Cycle. A comprehensive search for existing SCI-specific CPGs was conducted. The quality of eligible CPGs was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. An expert panel ( = 52) convened, and groups of relevant experts met to review and recommend adoption or refinement of existing recommendations or develop new recommendations based on evidence from systematic reviews conducted by the Spinal Cord Injury Research Evidence (SCIRE) team. The expert panel voted to approve selected recommendations using an online survey tool.
RESULTS
The Can-SCIP Guideline includes 585 total recommendations from 41 guidelines, 96 recommendations that pertain to the Components of the Ideal SCI Care System section, and 489 recommendations that pertain to the Management of Secondary Health Conditions section. Most recommendations ( = 281, 48%) were adopted from existing guidelines without revision, 215 (36.8%) recommendations were revised for application in a Canadian context, and 89 recommendations (15.2%) were created .
CONCLUSION
The Can-SCIP Guideline is the first living comprehensive guideline for adults with SCI in Canada across the care continuum.
简介
脊髓损伤（SCI）是一种改变生活的损伤，导致个体的感觉、运动和自主功能发生复杂的变化，这些变化在很大程度上取决于脊髓损伤的程度和严重程度。现有的 SCI 特定临床实践指南（CPG）针对特定的损伤、健康状况或护理连续体的一部分，但未能解决个体护理过程中出现的所有重要临床问题。为了解决这一差距，一个由 SCI 领域的专业人员组成的跨专业小组召开会议，制定了加拿大脊髓损伤最佳实践（Can-SCIP）指南。本文概述了支持 Can-SCIP 指南制定过程的方法。
方法
使用指南适应周期开发了 Can-SCIP 指南。对现有的 SCI 特定 CPG 进行了全面搜索。使用评估指南研究与评价 II（AGREE II）工具评估合格 CPG 的质量。召集了一个专家小组（ = 52），并召集相关专家组审查并建议采纳或改进现有的建议，或根据脊髓损伤研究证据（SCIRE）小组进行的系统评价中的证据制定新的建议。专家小组使用在线调查工具投票批准选定的建议。
结果
Can-SCIP 指南包括来自 41 项指南的 585 项总建议，其中 96 项建议涉及理想 SCI 护理系统组成部分，489 项建议涉及继发性健康状况管理部分。大多数建议（ = 281，48%）是从现有指南中未经修订采纳的，215 项（36.8%）建议是为在加拿大应用而修订的，89 项（15.2%）建议是新制定的。
结论
Can-SCIP 指南是加拿大第一个涵盖整个护理连续体的成人 SCI 综合指南。
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