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门诊普通内科的最新进展:2021 年发表的具有改变实践意义的证据。

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2021.

机构信息

Division of Community Internal Medicine, Geriatrics and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minn.

Division of Community Internal Medicine, Geriatrics and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minn.

出版信息

Am J Med. 2022 Sep;135(9):1069-1074. doi: 10.1016/j.amjmed.2022.02.043. Epub 2022 Mar 31.

Abstract

It can be challenging to identify new evidence that may shift clinical practice within internal medicine. Synthesis of relevant articles and guideline updates can facilitate staying informed of these changes. The titles and abstracts from the 7 general internal medicine outpatient journals with highest impact factors and relevance were reviewed by 8 internal medicine physicians. Coronavirus disease 2019 research was excluded. The New England Journal of Medicine (NEJM), The Lancet, Journal of the American Medical Association (JAMA), The British Medical Journal (BMJ), Annals of Internal Medicine, JAMA Internal Medicine, and Public Library of Science Medicine were reviewed. Additionally, article synopsis collections and databases were reviewed: American College of Physicians Journal Club, NEJM Journal Watch, BMJ Evidence-Based Medicine, McMaster/DynaMed Evidence Alerts, and Cochrane Reviews. A modified Delphi method was used to gain consensus based on clinical relevance to outpatient internal medicine, potential impact on practice, and strength of evidence. Article qualities and importance were debated until consensus was reached. Clusters of articles pertinent to the same topic were considered together. In total, 8 practice-changing articles were included.

摘要

在内科医学中,识别可能改变临床实践的新证据可能具有挑战性。综合相关文章和指南更新可以帮助您了解这些变化。8 位内科医生对影响因子和相关性最高的 7 种普通内科门诊期刊的标题和摘要进行了审查。排除了与 2019 年冠状病毒病相关的研究。审查了《新英格兰医学杂志》(NEJM)、《柳叶刀》、《美国医学会杂志》(JAMA)、《英国医学杂志》(BMJ)、《内科医学年鉴》、《JAMA 内科杂志》和《公共科学图书馆医学》。此外,还审查了文章摘要集和数据库:美国医师学会杂志俱乐部、NEJM 期刊观察、BMJ 循证医学、麦克马斯特/DynaMed 证据警报和 Cochrane 评论。使用改良 Delphi 方法基于对外科医学门诊的临床相关性、对实践的潜在影响和证据强度来达成共识。在达成共识之前,对文章质量和重要性进行了辩论。与同一主题相关的文章聚类被一起考虑。总共纳入了 8 篇具有改变实践意义的文章。

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