Gastroenterology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Nottingham Digestive Diseases Centre, Translational Medical Sciences, University of Nottingham University Park Campus, Nottingham, UK
BMJ Open Gastroenterol. 2023 May;10(1). doi: 10.1136/bmjgast-2023-001139.
Refractory ulcerative proctitis presents a huge clinical challenge not only for the patients living with this chronic, progressive condition but also for the professionals who care for them. Currently, there is limited research and evidence-based guidance, resulting in many patients living with the symptomatic burden of disease and reduced quality of life. The aim of this study was to establish a consensus on the thoughts and opinions related to refractory proctitis disease burden and best practice for management.
A three-round Delphi consensus survey was conducted among patients living with refractory proctitis and the healthcare experts with knowledge on this disease from the UK. A brainstorming stage involving a focus group where the participants came up with an initial list of statements was completed. Following this, there were three rounds of Delphi surveys in which the participants were asked to rank the importance of the statements and provide any additional comments or clarifications. Calculation of mean scores, analysis of comments and revisions were performed to produce a final list of statements.
In total, 14 statements were suggested by the focus group at the initial brainstorming stage. Following completion of three Delphi survey rounds, all 14 statements reached consensus following appropriate revision.
We established consensus on the thoughts and opinions related to refractory proctitis from both the experts who manage this disease and the patients living with it. This represents the first step towards developing clinical research data and ultimately the evidence needed for best practice management guidance of this condition.
难治性溃疡性直肠炎不仅给患有这种慢性、进行性疾病的患者,也给照顾他们的专业人员带来了巨大的临床挑战。目前,研究和循证指导有限,导致许多患者承受着疾病的症状负担,生活质量下降。本研究旨在就难治性直肠炎疾病负担和最佳管理实践的相关想法和意见达成共识。
对来自英国的难治性直肠炎患者和具有该疾病知识的医疗保健专家进行了三轮德尔菲共识调查。完成了一个头脑风暴阶段,包括一个焦点小组,参与者提出了一份初始陈述清单。在此之后,进行了三轮德尔菲调查,要求参与者对陈述的重要性进行排名,并提供任何其他意见或澄清。通过计算平均分数、分析评论和修订,生成最终的陈述列表。
在最初的头脑风暴阶段,焦点小组提出了 14 条建议。完成三轮德尔菲调查后,经过适当修订,所有 14 条陈述均达成共识。
我们从管理这种疾病的专家和患有这种疾病的患者那里就难治性直肠炎的相关想法和意见达成了共识。这是为这种疾病制定最佳实践管理指南开发临床研究数据并最终提供所需证据的第一步。