近年来,指南的发展及其在所有医学领域的应用已大大扩展。然而,尽管有共同的证据基础,不同的专业协会和医疗保健当局提供的建议通常差异很大。心房颤动(AF)的快速发展以及针对AF的多种指南使其特别容易受到该问题的影响。许多非医学方面在指南的制定中很重要,如果不理解它们,对指南的正确解释是困难的。利益冲突,监管环境,和当地数据都影响指导方针。细致入微的措辞,资源可用性,和战略目的增加了指导方针建议的复杂性。本文回顾了来自世界各地的主要AF指南,并讨论了与科学证据基础无关的方面,以帮助执业医师理解并更好地利用不同的指南建议。
The development of
guidelines and their use in all areas of medicine has greatly expanded in recent years. However, despite a shared evidence base, recommendations provided by different professional societies and healthcare authorities often vary considerably. The rapid advances in atrial fibrillation (AF) and the multiplicity of guidelines devoted to AF have made it particularly susceptible to this problem. Many nonmedical aspects are important in the development of guidelines, and without understanding them correct interpretation of
guidelines is difficult. Conflicts of interest, the regulatory environment, and local data all influence
guidelines. Nuanced wording, resource availability, and strategic purpose add complexity to
guideline recommendations. This article reviews major AF guidelines from around the world and discusses aspects which have nothing to do with the scientific evidence base in order to help the practicing physician understand and make better use of differing
guideline recommendations.