Abstract:
In June 2020, the Taskforce of the Guideline Workshop 2019 convened via teleconferencing to initiate a pilot project that demonstrates the various processes and considerations involved in developing high-quality, evidence-based clinical practice guidelines for the medical management of individuals with type 2 diabetes (T2D) and its associated comorbidities, including cardiovascular disease (CVD) and chronic kidney disease (CKD). The goal of the pilot project was to create evidence-based guidelines for use of sodium-glucose transport protein 2 inhibitors (SGLT2-I) when managing very high risk T2D patients, evidenced by the presence of both CVD and CKD. For this purpose the Taskforce represented a guideline panel and made use of synthesized evidence from an ongoing BMJ Rapid Recommendations project on SGLT2-I and GLP-1 receptor agonists. Results from the Taskforce pilot project demonstrated the value, feasibility and utility of using a step-wise approach to identifying and grading evidence and then developing actionable recommendations for utilizing SGLT2-I in this at-risk T2D population. This report describes the various steps involved in the process and explains how it can be utilized to rapidly develop recommendations in a format that is easy to use and can be quickly updated as new evidence becomes available, also within the emerging concept of living guidelines.
摘要:
2020年6月,2019年指南研讨会工作组通过电话会议召集了一个试点项目,该项目展示了开发高质量,2型糖尿病(T2D)及其相关合并症患者的医学管理的循证临床实践指南,包括心血管疾病(CVD)和慢性肾脏疾病(CKD)。试点项目的目标是创建基于证据的指南,用于管理非常高风险的T2D患者时使用钠-葡萄糖转运蛋白2抑制剂(SGLT2-I)。CVD和CKD的存在证明。为此,工作组代表了一个指南小组,并利用了正在进行的关于SGLT2-I和GLP-1受体激动剂的BMJ快速建议项目的综合证据。工作组试点项目的结果表明了这一价值,使用逐步方法来识别和分级证据,然后在该高危T2D人群中使用SGLT2-I制定可操作的建议的可行性和实用性。本报告描述了该过程中涉及的各个步骤,并解释了如何利用它以易于使用的格式快速开发建议,并且可以随着新证据的出现而快速更新。也在新兴的生活准则概念内。