Crit Care Med. 1993 Apr;21(4):615-24.
To test a model for the assessment of critical care technology. To develop practice guidelines for the use of pulse oximetry.
A computer-assisted search of the English language literature and interviews with recognized experts in the field of pulse oximetry.
Those studies that addressed one or more of the seven questions contained in our technology assessment template were analyzed. Study design was not a factor in article selection. However, the lack of well-designed clinical outcome studies was an important factor in determining the method of practice policy development we utilized.
A focus person summarized the data from the selected studies that related to each of the seven assessment questions. The preliminary data summary developed by the focus person was further analyzed and refined by the task force and then sent to 16 expert reviewers for comment. These expert comments were considered by the task force, and this final consensus report was developed.
Pulse oximetry combines the principles of spectrophotometry and plethysmography to noninvasively measure oxygen saturation with a high degree of accuracy over the range of 80% to 100% saturation, assuming the device is being used according to the manufacturer's instructions and without any adverse operating conditions. The appropriate clinical uses of pulse oximetry fall into one of two broad categories: as a warning system based on continuous real-time measurement of arterial desaturation, or as an end-point for titration of therapeutic interventions. There are no published studies that allow for definitive, outcome-based conclusions concerning either the clinical impact or cost-benefit ratio of pulse oximetry.
The model developed for technology assessment proved to be appropriate for assessing pulse oximetry. The available data have allowed us to develop an evidence-based practice policy for the use of pulse oximetry in critical care. Critical care clinicians, researchers, and industry have a shared responsibility to provide valid outcome and efficacy studies of new technologies.
测试一种用于评估重症监护技术的模型。制定脉搏血氧饱和度测定法使用的实践指南。
对英文文献进行计算机辅助检索，并采访脉搏血氧饱和度测定领域的知名专家。
分析那些涉及我们技术评估模板中七个问题中的一个或多个问题的研究。研究设计不是文章选择的因素。然而，缺乏设计良好的临床结局研究是确定我们采用的实践政策制定方法的一个重要因素。
一名核心人员总结了所选研究中与七个评估问题中的每一个相关的数据。核心人员制定的初步数据总结由工作组进一步分析和完善，然后发送给16名专家评审员征求意见。工作组考虑了这些专家意见，并制定了这份最终共识报告。
脉搏血氧饱和度测定法结合了分光光度法和容积描记法的原理，在饱和度80%至100%的范围内，在按照制造商说明使用且无任何不利操作条件的情况下，以高度准确性无创测量血氧饱和度。脉搏血氧饱和度测定法的适当临床用途可分为两大类：作为基于动脉血氧饱和度持续实时测量的警报系统，或作为治疗干预滴定的终点。没有已发表的研究能够就脉搏血氧饱和度测定法的临床影响或成本效益比得出明确的、基于结局的结论。
为技术评估开发的模型被证明适用于评估脉搏血氧饱和度测定法。现有数据使我们能够制定一项基于证据的实践政策，用于在重症监护中使用脉搏血氧饱和度测定法。重症监护临床医生、研究人员和行业有共同责任提供关于新技术的有效结局和疗效研究。
