Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Nutritional Sciences, King's College London, London, UK.
J Hum Nutr Diet. 2023 Feb;36(1):336-377. doi: 10.1111/jhn.13054. Epub 2022 Jul 21.
Despite increased awareness of diet and nutrition being integral to the management of patients with inflammatory bowel disease (IBD), there are gaps in the knowledge of IBD healthcare providers regarding nutrition. Furthermore, high quality evidence on nutritional assessment and dietary management of IBD is limited. A Delphi consensus from a panel of experts allows for best-practice guidelines to be developed, especially where high quality evidence is limited. The aim was to develop guidelines for the nutritional assessment and dietary management of IBD using an eDelphi online consensus agreement platform.
Seventeen research topics related to IBD and nutrition were systematically reviewed. Searches in Cochrane, Embase®, Medline® and Scopus® electronic databases were performed. GRADE was used to develop recommendations. Experts from the IBD community (healthcare professionals and patients with IBD) were invited to vote anonymously on the recommendations in a custom-built online platform. Three rounds of voting were carried out with updated iterations of the recommendations and evaluative text based on feedback from the previous round.
From 23,824 non-duplicated papers, 167 were critically appraised. Fifty-five participants completed three rounds of voting and 14 GRADE statements and 42 practice statements achieved 80% consensus. Comprehensive guidance related to nutrition assessment, nutrition screening and dietary management is provided.
Guidelines on the nutritional assessment and dietary management of IBD have been developed using evidence-based consensus to improve equality of care. The statements and practice statements developed demonstrate the level of agreement and the quality and strength of the guidelines.
尽管人们越来越意识到饮食和营养对于炎症性肠病(IBD)患者的管理至关重要,但 IBD 医疗保健提供者在营养方面的知识仍存在差距。此外,关于 IBD 的营养评估和饮食管理的高质量证据有限。专家小组的德尔菲共识允许制定最佳实践指南,尤其是在高质量证据有限的情况下。本研究旨在使用电子德尔菲在线共识协议平台制定 IBD 的营养评估和饮食管理指南。
系统地审查了与 IBD 和营养相关的 17 个研究课题。在 Cochrane、Embase®、Medline®和 Scopus®电子数据库中进行了检索。使用 GRADE 制定建议。邀请来自 IBD 社区(医疗保健专业人员和 IBD 患者)的专家在定制的在线平台上匿名对建议进行投票。进行了三轮投票,根据前一轮的反馈,对建议和评估文本进行了更新迭代。
从 23824 篇非重复论文中,批判性评价了 167 篇。55 名参与者完成了三轮投票,有 14 项 GRADE 陈述和 42 项实践陈述达成了 80%的共识。提供了有关营养评估、营养筛查和饮食管理的综合指导。
使用基于证据的共识制定了 IBD 营养评估和饮食管理指南,以改善护理的公平性。制定的陈述和实践陈述表明了共识的程度以及指南的质量和强度。