目的:这项研究的目的是就直至行走年龄的特发性先天性马蹄内翻足(CTEV)的治疗达成协议,以便为从业者提供基准并指导一致,为CTEV儿童提供高质量的护理。
方法:共识过程遵循既定的Delphi方法,并具有预定程度的一致性。该过程包括以下步骤:建立指导小组;指导小组会议,生成语句,并对照文献进行检查;两轮德尔福调查;最后的共识会议。指导组成员和Delphi调查参与者均为英国儿童骨科手术学会(BSCOS)成员。采用描述性统计方法对德尔菲调查结果进行分析。报告结果遵循研究和评估清单指南的评估。
结果:BSCOS选择的指导小组,指导小组会议,德尔福调查,最终的共识会议都遵循了事先商定的协议。共有153/243名成员在第一轮德尔福(63%)中投票,在第二轮(86%)中投票132名。在提交给第一轮德尔福的61份声明中,43在\'中达成共识,没有达成“共识”的声明,18人达成了“没有共识”。根据第一轮的建议,删除了四项声明,并添加了一项新声明。在提交给第2轮的15项声明中,第12轮达成了“共识”,没有达成“共识”的声明,三人达成了“未达成共识”,并在最终共识会议之后进行了讨论和包括在内。为简单起见,将两个陈述合并在一起。最后的协商一致文件包括57个发言,分为六个连续阶段。
结论:我们已经发表了关于治疗特发性CTEV直至行走年龄的共识文件。这将为英国的护理标准提供基准,并有助于减少治疗和结果的地理差异。适当的传播和执行将是其成功的关键。引用本文:骨关节J2022;104-B(6):758-764。
OBJECTIVE: The aim of this study was to gain an agreement on the management of idiopathic congenital talipes equinovarus (
CTEV) up to walking age in order to provide a benchmark for practitioners and guide consistent, high-quality care for children with
CTEV.
METHODS: The consensus process followed an established Delphi approach with a predetermined degree of agreement. The process included the following steps: establishing a steering group; steering group meetings, generating statements, and checking them against the literature; a two-round Delphi survey; and final consensus meeting. The steering group members and Delphi survey participants were all British Society of Children\'s Orthopaedic Surgery (BSCOS) members. Descriptive statistics were used for analysis of the Delphi survey results. The Appraisal of
Guidelines for Research & Evaluation checklist was followed for reporting of the results.
RESULTS: The BSCOS-selected steering group, the steering group meetings, the Delphi survey, and the final consensus meeting all followed the pre-agreed protocol. A total of 153/243 members voted in round 1 Delphi (63%) and 132 voted in round 2 (86%). Out of 61 statements presented to round 1 Delphi, 43 reached \'consensus in\', no statements reached \'
consensus out\', and 18 reached \'no
consensus\'. Four statements were deleted and one new statement added following suggestions from round 1. Out of 15 statements presented to round 2, 12 reached \'consensus in\', no statements reached \'consensus out\', and three reached \'no consensus\' and were discussed and included following the final consensus meeting. Two statements were combined for simplicity. The final consensus document includes 57 statements allocated into six successive stages.
CONCLUSIONS: We have produced a
consensus document for the treatment of idiopathic
CTEV up to walking age. This will provide a benchmark for standard of care in the UK and will help to reduce geographical variability in treatment and outcomes. Appropriate dissemination and implementation will be key to its success. Cite this article: Bone Joint J 2022;104-B(6):758-764.