在大流行的背景下,临床实践指南(CPG)的快速发展至关重要。指南开发过程包括指南主题的优先级排序,问题和健康结果。本案例研究描述了一种新方法的应用,用于确定问题的优先级,并对COVID-19牙科指南的健康结果的重要性进行评分。
小组成员对主题和问题的总体重要性进行了评级,使用9点量表(1=最不重要;9=最重要)。此外,如果多个问题获得相同的总体重要性评级,他们对六个标准进行了评级:在实践中常见,实践中的不确定性,在实践中的变化,新的证据,成本后果,以前没有处理过。小组成员还对每个结果的重要性进行了评估,用健康结果描述符定义,使用9点量表和视觉模拟量表上的健康结果效用。通过Spearman相关系数检验了每个标准与总体问题重要性之间的相关性。
在七个主题中,四个被评为高优先级,三个被评为重要,但不是高度优先。在指南中,36%的问题(18/50)被评为高优先级,64%(32/50)被评为重要问题,但不是高优先级。在11项成果中,72.7%被评为决策关键。平均效用等级为0.57(SD0.32),最小平均评分为0.16,最大评分为0.76(SD0.23)。
本案例研究表明,这种方法提供了一种严格和透明的方法来进行指南主题的优先排序。问题和健康结果。
In the context of a pandemic, the rapid development of clinical practice
guidelines (CPGs) is critical. The
guideline development process includes prioritization of the
guideline topic, questions and health outcomes. This case study describes the application of a new methodology to prioritize questions and rate the importance of health outcomes for a COVID-19 dental
guideline.
Panel members rated the topic and the questions\' overall importance, using a 9-point scale (1 = least important; 9 = most important). In addition, they rated six criteria if multiple questions received the same overall importance rating: common in practice, uncertainty in practice, variation in practice, new evidence available, cost consequences, not previously addressed. Panellists also rated the importance of each outcome, defined with health outcome descriptors, using a 9-point scale and the utility of health outcomes on a visual analogue scale. The correlation between each criterion and overall question importance was tested by Spearman correlation coefficient.
Of seven topics, four were rated as high priority and three were rated as important, but not of high priority. Thirty-six percent of the questions (18/50) were rated as high priority to address in the
guideline and 64% (32/50) were rated as an important question but not of high priority. Of the 11 outcomes, 72.7% were rated as critical for decision making. The mean utility rating was 0.57 (SD 0.32), with a minimum mean rating of 0.16 and a maximum of 0.76 (SD 0.23).
This case study demonstrated that this approach provides a rigorous and transparent methodology to conduct the prioritizations of
guideline topics, questions and health outcomes.