Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA, 19104, USA.
Division of Trauma and Emergency Surgery, Orebro University Hospital and Faculty of School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden.
Eur J Trauma Emerg Surg. 2023 Feb;49(1):5-15. doi: 10.1007/s00068-022-02045-3. Epub 2022 Jul 15.
For some surgical conditionns and scientific questions, the "real world" effectiveness of surgical patient care may be better explored using a multi-institutional time-bound observational cohort assessment approach (termed a "snapshot audit") than by retrospective review of administrative datasets or by prospective randomized control trials. We discuss when this might be the case, and present the key features of developing, deploying, and assessing snapshot audit outcomes data.
A narrative review of snapshot audit methodology was generated using the Scale for the Assessment of Narrative Review Articles (SANRA) guideline. Manuscripts were selected from domains including: audit design and deployment, statistical analysis, surgical therapy and technique, surgical outcomes, diagnostic testing, critical care management, concomitant non-surgical disease, implementation science, and guideline compliance.
Snapshot audits all conform to a similar structure: being time-bound, non-interventional, and multi-institutional. A successful diverse steering committee will leverage expertise that includes clinical care and data science, coupled with librarian services. Pre-published protocols (with specified aims and analyses) greatly helps site recruitment. Mentored trainee involvement at collaborating sites should be encouraged through manuscript contributorship. Current funding principally flows from medical professional organizations.
The snapshot audit approach to assessing current care provides insights into care delivery, outcomes, and guideline compliance while generating testable hypotheses.
对于某些外科情况和科学问题，使用多机构限时观察性队列评估方法（称为“快照审核”）来探索外科患者护理的“真实世界”效果可能比通过回顾性审查行政数据集或前瞻性随机对照试验更好。我们讨论了在什么情况下可能如此，并介绍了开发、部署和评估快照审核结果数据的关键特征。
使用叙事性综述评估标准 (SANRA) 指南生成了快照审核方法的叙述性综述。从包括以下领域的文献中选择了论文：审核设计和部署、统计分析、外科治疗和技术、手术结果、诊断测试、重症监护管理、伴随非外科疾病、实施科学和指南合规性。
快照审核都符合类似的结构：限时、非干预性和多机构。一个成功的多元化指导委员会将利用包括临床护理和数据科学在内的专业知识，以及图书馆员服务。预先发布的方案（具有指定的目标和分析）极大地有助于站点招募。应通过论文贡献鼓励合作站点的受训学员参与。目前的资金主要来自医疗专业组织。
评估当前护理的快照审核方法提供了对护理提供、结果和指南合规性的深入了解，同时产生了可测试的假设。
