From the Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA (Shapiro), and the Department of Orthopaedic Surgery, Standford University Medical Center, Redwood City, CA (Kamal).
J Am Acad Orthop Surg. 2022 Aug 1;30(15):691-695. doi: 10.5435/JAAOS-D-22-00139. Epub 2022 Mar 15.
The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria for the Treatment of Distal Radius Fractures . Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of various treatments in the management of distal radius fractures. The Appropriate Use Criteria for the Treatment of Distal Radius Fractures were derived by identifying clinical indications typical of patients with a distal radius fracture in clinical practice. These indications were most often variables observable by the clinician, including symptoms or results of diagnostic tests. In addition, "patient-level variables" (eg, activity level or demographics) can be considered. In total, 2,160 patient scenarios and 9 treatments were developed by the writing panel, a group of clinicians who are specialists in this Appropriate Use Criteria topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as "appropriate" (median rating, 7 to 9), "may be appropriate" (median rating, 4 to 6), or "rarely appropriate" (median rating, 1 to 3).
美国矫形外科医师学会已经制定了治疗桡骨远端骨折的适当使用标准。这些标准是通过结合医生的临床专业知识和循证信息制定的,旨在确定在桡骨远端骨折治疗中各种治疗方法的适当性。桡骨远端骨折治疗的适当使用标准是通过确定临床实践中桡骨远端骨折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变量,包括症状或诊断测试的结果。此外,还可以考虑“患者个体变量”(例如,活动水平或人口统计学特征)。在写作小组(由专门研究这一适当使用标准主题的临床医生组成)的努力下,共制定了 2160 个患者情况和 9 种治疗方案。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 9 分制对每个患者情况的治疗方法进行了适当性评估,以指定治疗方法为“适当”(中位数评分为 7 至 9)、“可能适当”(中位数评分为 4 至 6)或“很少适当”(中位数评分为 1 至 3)。