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美国先天性巨细胞病毒临床实践指南及模式的定性评估

A Qualitative Assessment of Clinical Practice Guidelines and Patterns for Congenital Cytomegalovirus in the United States.

作者信息

Kalb Stephanie, Diaz-Decaro John, Tossonian Harout, Natenshon Andrew, Panther Lori, Mansi James, Gibson Laura

机构信息

Moderna, Inc., Cambridge, MA 02139, USA.

Departments of Medicine and of Pediatrics, UMass Chan Medical School, Worcester, MA 01655, USA.

出版信息

Int J Neonatal Screen. 2023 Jun 30;9(3):37. doi: 10.3390/ijns9030037.

Abstract

Cytomegalovirus (CMV) infection during pregnancy may result in long-term health problems for children with congenital CMV (cCMV). Currently, no prevention or treatment interventions are approved by the Food and Drug Administration for a cCMV indication. Healthcare provider and public awareness is low, and formal clinical practice guidelines and local practice patterns vary. A pilot study of eight cCMV experts was performed using qualitative semi-structured interviews to better understand clinical practice guidelines and patterns in the United States. Results from participant interviews highlighted the need for better prenatal diagnostic techniques, broader neonatal screening opportunities, and more robust evidence supporting intervention strategies. Healthcare provider and public partnerships are essential for advancing cCMV guidelines and improving care delivery. Our results provide a preliminary knowledge base and framework for developing a consensus cCMV research agenda to address evidence gaps that limit the revision of clinical practice guidelines. The changes in clinical practice patterns that may arise as a result of further research have the potential to reduce risk during pregnancy and improve care for children with cCMV infection.

摘要

孕期巨细胞病毒(CMV)感染可能会给先天性CMV(cCMV)患儿带来长期健康问题。目前,美国食品药品监督管理局尚未批准任何针对cCMV适应症的预防或治疗干预措施。医疗服务提供者和公众的认知度较低,并且正式的临床实践指南和当地实践模式各不相同。对八名cCMV专家进行了一项试点研究,采用定性半结构化访谈,以更好地了解美国的临床实践指南和模式。参与者访谈的结果强调了需要更好的产前诊断技术、更广泛的新生儿筛查机会以及更有力的证据来支持干预策略。医疗服务提供者与公众之间的伙伴关系对于推进cCMV指南和改善医疗服务至关重要。我们的研究结果为制定一项共识性的cCMV研究议程提供了初步的知识库和框架,以解决限制临床实践指南修订的证据空白。进一步研究可能导致的临床实践模式变化,有可能降低孕期风险并改善对cCMV感染患儿的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e3/10366839/2314dbe022bd/IJNS-09-00037-g001.jpg

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