关键词: Delphi survey burn wound infection burns diagnostic indicators systematic review

Mesh : Burns / complications Clinical Decision-Making Clinical Trials as Topic Consensus Development Conferences as Topic Delphi Technique Humans Research Design Surveys and Questionnaires Systematic Reviews as Topic Wound Infection / diagnosis etiology

来  源:   DOI:10.1136/bmjopen-2018-026056   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
Systematic reviews of high-quality randomised controlled trials are necessary to identify effective interventions to impact burn wound infection (BWI) outcomes. Evidence synthesis requires that BWI is reported in a consistent manner. Cochrane reviews investigating interventions for burns report that the indicators used to diagnose BWI are variable or not described, indicating a need to standardise reporting. BWI is complex and diagnosed by clinician judgement, informed by patient-reported symptoms, clinical signs, serum markers of inflammation and bacteria in the wound. Indicators for reporting BWI should be important for diagnosis, frequently observed in patients with BWI and assessed as part of routine healthcare. A minimum (core) set of indicators of BWI, reported consistently, will facilitate evidence synthesis and support clinical decision-making.
The Infection Consensus in Burns study aims to identify a core indicator set for reporting the diagnosis of BWI in research studies.
(1) Evidence review: a systematic review of indicators used in trials and observational studies reporting BWI outcomes to identify a long list of candidate indicators; (2) refinement of the long list into a smaller set of survey questions with an expert steering group; (3) a two-round Delphi survey with 100 multidisciplinary expert stakeholders, to achieve consensus on a short list of indicators; (4) a consensus meeting with expert stakeholders to agree on the BWI core indicator set.
Participants will be recruited through professional bodies, such that ethical approval from the National Health Service (NHS) Health Research Authority (HRA) is not needed. The core indicator set will be disseminated through peer-reviewed publication, co-production with journal editors, research funders and professional bodies, and presentation at national conferences.
CRD42018096647.
摘要:
高质量随机对照试验的系统评价对于确定影响烧伤创面感染(BWI)结局的有效干预措施是必要的。证据综合要求以一致的方式报告BWI。Cochrane回顾调查烧伤干预措施的报告,用于诊断BWI的指标是可变的或没有描述,表明需要标准化报告。BWI是复杂的,由临床医生判断诊断,根据患者报告的症状,临床体征,伤口中炎症和细菌的血清标志物。报告BWI的指标对于诊断应该很重要,经常在BWI患者中观察到,并作为常规医疗保健的一部分进行评估。BWI的最低(核心)指标集,报告一致,将促进证据综合和支持临床决策。
“烧伤感染共识”研究旨在确定一个核心指标集,用于在研究中报告BWI的诊断。
(1)证据审查:对报告BWI结果的试验和观察性研究中使用的指标进行系统审查,以确定一长串候选指标;(2)与专家指导小组将长列表细化为一组较小的调查问题;(3)与100个多学科专家利益相关者进行两轮Delphi调查,就指标的简短清单达成共识;(4)与专家利益相关方举行共识会议,就BWI核心指标集达成共识。
参与者将通过专业机构招募,这样,从国家卫生服务(NHS)健康研究机构(HRA)的伦理批准是不需要的。核心指标集将通过同行评审出版物传播,与期刊编辑合作制作,研究资助者和专业机构,并在全国会议上发言。
CRD42018096647。
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