关键词: COVID-19 Gestion des soins Guidelines Neuro-urologie Neuro-urology Practice management Priorisation Prioritization Recommandations

Mesh : COVID-19 Delphi Technique Humans Pandemics Pelvis Urology

来  源:   DOI:10.1016/j.purol.2022.04.009

Abstract:
OBJECTIVE: During the COVID-19 pandemic, a care reorganization was mandatory, and affected patients in different areas, including management of neurogenic lower urinary tract dysfunction. This work aims to provide validated schedule concerning the assessment and management of patients in neuro-urology.
METHODS: Based on a literature review and their own expertise, a steering committee composed of urologists and physical medicine and rehabilitation practitioners generated a comprehensive risk-situation list and built a risk scale. A panel of French-speaking experts in neuro-urology was asked to define the timing for each clinical situation and validated these new recommendations through a Delphi process approach.
RESULTS: The 49 experts included in the rating group validated 163 propositions among the 206 initial items. The propositions were divided into four domains - diagnosis and assessment, treatment, follow-up, and complications - and two sub-domains - general (applicable for all neurological conditions) and condition-specific (varying according to the neurological condition (spinal cord injury, multiple sclerosis, brain injury, Parkinsonism, spinal dysraphism, lower motor neuron lesions)).
CONCLUSIONS: This multidisciplinary collaborative work generates recommendations based on expert opinion, providing a validated timing for assessment and management of patients in neuro-urology which may help clinicians to reorganize their patients\' list with a personalized medicine approach, in a context of health crisis or not.
摘要:
目标:在COVID-19大流行期间,护理重组是强制性的,以及不同地区受影响的患者,包括神经源性下尿路功能障碍的治疗。这项工作旨在提供有关神经泌尿科患者评估和管理的有效时间表。
方法:根据文献综述和他们自己的专业知识,由泌尿科医师、物理医学和康复医生组成的指导委员会编制了一份全面的风险状况清单,并建立了风险量表。要求一组讲法语的神经泌尿学专家确定每种临床情况的时机,并通过Delphi过程方法验证这些新建议。
结果:评级组的49位专家验证了206个初始项目中的163个命题。命题分为四个领域-诊断和评估,治疗,后续行动,和并发症-和两个子领域-一般(适用于所有神经系统疾病)和条件特异性(根据神经系统状况(脊髓损伤,多发性硬化症,脑损伤,帕金森病,脊髓发育不良,下运动神经元病变)。
结论:这项多学科协作工作根据专家意见提出建议,为神经泌尿科患者的评估和管理提供一个经过验证的时机,这可能有助于临床医生用个性化的医学方法重新组织他们的患者列表,在健康危机的背景下。
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