METHODS: A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1-9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures-kappa coefficient ([Formula: see text]) value > 0.61.
RESULTS: After three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease.
CONCLUSIONS: This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years.
方法:采用德尔菲法过程,涉及三轮问卷,其中前两轮分别在线完成,第三轮在虚拟平台上与所有小组成员讨论。成立了一个由34名认证专家组成的国家多学科专家小组,由16位鼻学家组成,7名过敏症患者,和11名呼吸科医生,他们以1-9的比例评估了20份原始声明并提供了评论。所有评级均按平均值进行了定量审查,中位数,mode,范围,标准偏差和评估者间可靠性。共识由相对评分者间可靠性度量-卡帕系数([公式:见正文])值>0.61定义。
结果:经过三轮,共有22项声明达成共识。本白皮书仅包含最终商定的声明,以及关于在上呼吸道疾病患者中使用生物制剂的声明的明确理由和支持。
结论:本白皮书从多学科的角度为加拿大医生使用生物疗法治疗上呼吸道疾病提供了指导。但药物和手术方案最终应针对患者进行个体化治疗。随着越来越多的生物制剂可用和更多试验的发布,我们将每隔几年提供本白皮书的更新版本。