consensus statement

共识声明
  • 文章类型: Journal Article
    这篇综述确定了临床实践指南(CPG)和共识声明(CS),其中包括对社区居住的老年人的长期护理的建议。此外,它使用研究和评估指南评估(AGREEII)工具评估其质量,以确定高质量指南和高质量指南的综合建议,并使用AGREE-RecommendationExcellence(AGREE-REX)工具评估这些指南的质量。在MEDLINE进行了系统搜索(2023年11月),PubMed,准则国际网络(GIN),国家健康与护理卓越研究所(NICE),新西兰准则小组(NZGG),安大略省注册护士协会(RNAO),国家准则信息交换所(NGC),和苏格兰校际指南网络(SIGN)。两名审稿人使用AGREEII独立选择和评估文章。召开了一次会议,使用AGREE-REX评估指南的质量(AGREEII平均得分>70%)。分析包括14个CPG和2个CS。其中,7个CPGs达到>70%的标准,“范围和目的”域获得最高分,为85.43(±17.87),和“适用性”领域得分最低,为46.93(±26.74)。关于AGREE-REX的分数,这七个CPG被认为是“中等”,“临床适用性”领域的得分最高,为61.29%(±10.80),“值和首选项”领域的得分最低,为38.14%(±9.26)。从七个高质量的CPG中综合了四个主题:规划和提供以人为本的家庭护理,认知障碍,以及视力受损和跌倒的筛查。社区居住老年人长期护理的CPG和CSS的质量还有改进的空间,需要更高质量的指南来满足社区居住的老年人的长期护理需求。
    This review identified clinical practice guidelines (CPGs) and consensus statements (CSs) that include recommendations on long-term care for community-dwelling older adults. Additionally, it assessed their quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool to determine high-quality guidelines and synthesis recommendations from high-quality guidelines and evaluate the quality of these guidelines using the AGREE-Recommendation Excellence (AGREE-REX) tool. A systematic search was performed (November 2023) in MEDLINE, PubMed, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), New Zealand Guidelines Group (NZGG), Registered Nurses\' Association of Ontario (RNAO), National Guideline Clearinghouse (NGC), and Scottish Intercollegiate Guidelines Network (SIGN). Two reviewers independently selected and assessed the articles using AGREE II. A meeting was held to appraise the quality of the guidelines (AGREE II mean score >70 %) using AGREE-REX. The analysis included 14 CPGs and 2 CSs. Of these, 7 CPGs reached the standard of >70 %, the \'Scope and purpose\' domain obtained the highest score with 85.43 (± 17.87), and the \'Applicability\' domain scored lowest with 46.93 (± 26.74). Regarding the score of AGREE-REX, the seven CPGs were considered as \'moderate\', with the \'Clinical Applicability\' domain having the highest score of 61.29 % (±10.80) and the \'Values and Preferences\' domain having the lowest score of 38.14 % (±9.26). Four themes were synthesised from the seven high-quality CPGs: planning and delivering person-centred home care, cognitive impairment, and screening for impaired vision and falls. The quality of CPGs and CSs on long-term care for community-dwelling older adults has room for improvement, and higher-quality guidelines are required to meet the long-term care needs of community-dwelling older adults.
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  • 文章类型: Journal Article
    抗癌药物诱发的间质性肺病(DIILD)越来越受到临床关注,相关指导文件的质量变得至关重要。我们的目的是评估抗癌DIILD文件的质量并总结建议。临床实践指南(CPG)和评估建议的共识声明,治疗,并在电子数据库中搜索了抗癌DIILD的监测,指南组织的网站,和专业社团。文件的质量使用评估指南II(AGREEII)方法进行评估,并对具体建议进行汇总和比较,以分析文档之间的一致性。共有11份文件符合资格,包括6个CPG和5个共识声明。AGREEII评估的质量差异很大,文档域之间和跨域文档之间。范围和目的以及演示文稿清晰度的领域获得了最高的中位数得分,而利益相关者参与领域得分最低。文件之间的建议不一致,特别是关于类固醇方案的选择。指导文件的方法质量需要提高,特别是在利益相关者参与的领域。关于具体评价建议的文件存在不一致之处,治疗和,监测抗癌DIILD,多学科专家之间需要进一步讨论以达成协议。特别是,我们将注意力集中在类固醇治疗方案的差异上,未来仍需研究与激素治疗相关的不良事件的风险,并发现精确的生物标志物.
    Anticancer drug-induced interstitial lung disease (DIILD) has received increasing clinical attention, and the quality of relevant guidance documents has become critical. Our purpose was to assess the quality of documents for anticancer DIILD and summarize the recommendations. Clinical practice guidelines (CPGs) and consensus statements with recommendations were searched in electronic databases, websites of guideline organizations, and professional societies. The quality of documents was assessed using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) methodology, and the specific recommendations were aggregated and compared. A total of 11 documents were eligible, including 6 CPGs and 5 consensus statements, and the quality of AGREE II assessments differed greatly. The domains of scope and purpose and clarity of presentation received the highest median scores, while the stakeholder involvement domain received the lowest score. Recommendations were inconsistent between documents, particularly regarding the selection of steroid regimens. The methodological quality of the guidance documents needs to be enhanced, especially in the domain of stakeholder involvement. Inconsistencies exist in documents, and further discussions among multidisciplinary experts are needed. Particularly, differences in steroid regimens require attentions, and researches on the risks of adverse events and discovery of precise biomarkers are necessary.
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  • 文章类型: Journal Article
    非关节炎性关节内髋关节疼痛,由各种病理引起的,导致运动范围受损,力量,balance,和神经肌肉控制。尽管功能性能测试在评估这些患者方面提供了有价值的见解,对于该患者人群的最佳检测方法尚无明确共识.
    本研究旨在就非关节炎性髋关节内疼痛患者功能表现测试的应用和选择建立专家共识。
    与14位物理治疗专家一起使用了改良的Delphi技术,国际髋关节镜学会(ISHA)的所有成员。小组成员参加了三轮问题和相关讨论,以就功能性能测试的应用和选择达成充分共识。
    专家小组同意在初始评估时应使用功能性能测试,重新评价,和放电,以及评估重返体育运动准备情况的标准。测试应作为神经肌肉控制的多模式评估的一部分,力量,运动范围,和平衡,根据患者的特征以分级的方式应用。临床医生应选择具有客观评分标准的功能表现测试,并优先使用具有支持心理测量学证据的测试。提供了具有不同强度水平的推荐功能性能测试列表。低强度功能性能测试包括在单个平面中控制速度而没有冲击。中等强度功能性能测试涉及在低冲击的多个平面中控制速度。高强度功能性能测试包括在具有更高冲击和敏捷性要求的多个平面中的更高速度。运动特定的运动测试应模仿患者的特定活动或运动。
    这项国际共识声明为临床医生选择和利用非关节炎性髋关节内疼痛患者的功能表现测试提供了建议。这些建议将鼓励物理治疗评估期间临床医生之间更大的一致性和标准化。
    UNASSIGNED: Non-arthritic intra-articular hip pain, caused by various pathologies, leads to impairments in range of motion, strength, balance, and neuromuscular control. Although functional performance tests offer valuable insights in evaluating these patients, no clear consensus exists regarding the optimal tests for this patient population.
    UNASSIGNED: This study aimed to establish expert consensus on the application and selection of functional performance tests in individuals presenting with non-arthritic intra-articular hip pain.
    UNASSIGNED: A modified Delphi technique was used with fourteen physical therapy experts, all members of the International Society for Hip Arthroscopy (ISHA). The panelists participated in three rounds of questions and related discussions to reach full consensus on the application and selection of functional performance tests.
    UNASSIGNED: The panel agreed that functional performance tests should be utilized at initial evaluation, re-evaluations, and discharge, as well as criterion for assessing readiness for returning to sports. Tests should be as part of a multimodal assessment of neuromuscular control, strength, range of motion, and balance, applied in a graded fashion depending on the patient\'s characteristics. Clinicians should select functional performance tests with objective scoring criteria and prioritize the use of tests with supporting psychometric evidence. A list of recommended functional performance tests with varying intensity levels is provided. Low-intensity functional performance tests encompass controlled speed in a single plane with no impact. Medium-intensity functional performance tests involve controlled speed in multiple planes with low impact. High-intensity functional performance tests include higher speeds in multiple planes with higher impact and agility requirements. Sport-specific movement tests should mimic the patient\'s particular activity or sport.
    UNASSIGNED: This international consensus statement provides recommendations for clinicians regarding selection and utilization of functional performance tests for those with non-arthritic intra-articular hip pain. These recommendations will encourage greater consistency and standardization among clinicians during a physical therapy assessment.
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  • 文章类型: Journal Article
    由于缺乏关于纵向基础重症监护超声心动图(BCCE)培训的高质量研究,专家意见指南指导了BCCE能力教育标准和过程。然而,由于指南制定过程中的方法论缺陷,现有指南缺乏精确的细节。
    使用证据和专家意见,制定关于BCCE培训的方法上稳健的指南,详细说明每个步骤的具体标准,我们使用经过验证的AGREE-II工具的原理进行了修改的Delphi过程.根据系统评价,选择了以下领域:纵向BCCE课程的组成部分;图像采集和图像解释的合格等级标准;形成性/总结性评估和最终能力过程.在2020年4月至2021年5月期间,共有21名BCCE专家参加了四轮比赛。第一轮和第二轮使用了五份基于网络的问卷,包括用于向个别小组成员提出问题的分支逻辑软件。在第3轮(视频会议)中,小组以投票方式最终确定了建议。在期刊同行评审过程中,第四轮是作为基于网络的问卷进行的。在每一轮之后,每个项目的一致性阈值确定为项目纳入≥80%,项目排除≤30%.
    在第1轮和第2轮之后,就114个项目中的62个达成了协议。对于49个未解决的项目,在第3轮中增加了12个项目,有56个达成协议,还有5个项目尚未解决。达成共识,纵向BCCE培训必须包括入门培训,指导形成性培训,能力总结性评估,和最后的认知评估。需要多轮的项目包括二维视图,多普勒,心输出量,M模式测量,最小扫描次数,和合格等级标准。关于图像采集和图像解释质量的客观标准,小组同意维持形成性和终结性评估的相同标准,将BCCE的发现分为主要和次要,以及标准化的错误方法,准备进行终结性评估的标准,和监督选项。
    总之,本专家共识声明提出了关于纵向BCCE培训的全面循证建议.然而,这些建议需要前瞻性验证.
    With the paucity of high-quality studies on longitudinal basic critical care echocardiography (BCCE) training, expert opinion guidelines have guided BCCE competence educational standards and processes. However, existing guidelines lack precise detail due to methodological flaws during guideline development.
    To formulate methodologically robust guidelines on BCCE training using evidence and expert opinion, detailing specific criteria for every step, we conducted a modified Delphi process using the principles of the validated AGREE-II tool. Based on systematic reviews, the following domains were chosen: components of a longitudinal BCCE curriculum; pass-grade criteria for image-acquisition and image-interpretation; and formative/summative assessment and final competence processes.
    Between April 2020 and May 2021, a total of 21 BCCE experts participated in four rounds. Rounds 1 and 2 used five web-based questionnaires, including branching-logic software for directed questions to individual panelists. In round 3 (videoconference), the panel finalized the recommendations by vote. During the journal peer-review process, Round 4 was conducted as Web-based questionnaires. Following each round, the agreement threshold for each item was determined as ≥ 80% for item inclusion and ≤ 30% for item exclusion.
    Following rounds 1 and 2, agreement was reached on 62 of 114 items. To the 49 unresolved items, 12 additional items were added in round 3, with 56 reaching agreement and five items remaining unresolved. There was agreement that longitudinal BCCE training must include introductory training, mentored formative training, summative assessment for competence, and final cognitive assessment. Items requiring multiple rounds included two-dimensional views, Doppler, cardiac output, M-mode measurement, minimum scan numbers, and pass-grade criteria. Regarding objective criteria for image-acquisition and image-interpretation quality, the panel agreed on maintaining the same criteria for formative and summative assessment, to categorize BCCE findings as major vs minor and a standardized approach to errors, criteria for readiness for summative assessment, and supervisory options.
    In conclusion, this expert consensus statement presents comprehensive evidence-based recommendations on longitudinal BCCE training. However, these recommendations require prospective validation.
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  • 文章类型: Journal Article
    国际血液银行自动化共性理事会的细胞治疗编码和标记咨询小组和国际细胞与基因治疗学会间充质基质细胞(MSC)委员会正在提供有关简化适应培养的MSC的组织来源的具体建议。这些建议包括使用基于ISBT128术语模型的缩写,该模型指定了标准类别名称,以区分适应培养的MSC的细胞类型和组织来源。因此,来自骨髓的MSC是MSC(M),来自脐带血的MSC是MSC(CB),来自脂肪组织的MSC是MSC(AT),来自华顿胶质的MSC是MSC(WJ)。其他建议包括在临床前的全谱中使用这些缩写,转化和临床研究,以开发适应培养的MSC产品。这不适用于专注于调查发育起源的基础研究,不同组织中内源性祖细胞的身份或功能。这些建议将有助于协调术语来描述围绕培养适应MSC的研究和开发,其中许多用于临床和/或商业翻译。这些建议还将有助于使适应培养的MSC与其他细胞治疗产品的研究和开发工作保持一致。
    The Cellular Therapy Coding and Labeling Advisory Group of the International Council for Commonality in Blood Banking Automation and the International Society for Cell & Gene Therapy mesenchymal stromal cell (MSC) committee are providing specific recommendations on abbreviating tissue sources of culture-adapted MSCs. These recommendations include using abbreviations based on the ISBT 128 terminology model that specifies standard class names to distinguish cell types and tissue sources for culture-adapted MSCs. Thus, MSCs from bone marrow are MSC(M), MSCs from cord blood are MSC(CB), MSCs from adipose tissue are MSC(AT) and MSCs from Wharton\'s jelly are MSC(WJ). Additional recommendations include using these abbreviations through the full spectrum of pre-clinical, translational and clinical research for the development of culture-adapted MSC products. This does not apply to basic research focused on investigating the developmental origins, identity or functionalities of endogenous progenitor cells in different tissues. These recommendations will serve to harmonize nomenclature in describing research and development surrounding culture-adapted MSCs, many of which are destined for clinical and/or commercial translation. These recommendations will also serve to align research and development efforts on culture-adapted MSCs with other cell therapy products.
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  • 文章类型: Journal Article
    Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child\'s need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration.
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  • 文章类型: Guideline
    在与生活方式相关的环境中通过可穿戴设备评估诸如心率(HR)之类的生命体征为公共卫生相关的研究和应用提供了广泛的机会。通常,消费者可穿戴设备评估HR是基于光电体积描记术(PPG),其中HR由血液对发射光的吸收和反射决定。然而,方法学上的差异和验证过程中的缺陷阻碍了各种可穿戴设备评估HR有效性的可比性.迈向智能健康和福祉:身体活动评估网络(INTERLIVE)是由六所大学和一个工业合作伙伴共同发起的欧洲倡议。该联盟成立于2019年,致力于制定最佳实践建议,以评估消费者可穿戴设备和智能手机的有效性。本专家声明提供了消费者可穿戴设备通过PPG评估HR的最佳实践验证方案。建议是通过以下多阶段过程制定的:(1)基于系统评价和荟萃分析的首选报告项目的系统文献综述,(2)对有关在验证这些设备期间可能引入偏见的因素的更广泛文献进行非结构化审查,以及(3)INTERLIVE网络的循证专家意见。通过我们的系统文献综述,总共有44篇文章被认为是合格的。基于这些研究,更广泛的文献综述和我们的循证专家意见,我们提出了一个使用六个领域的标准化建议的验证框架:目标人群的考虑,标准度量,指标度量,测试条件,数据处理和统计分析。因此,本文提出了标准化消费者使用的基于PPG的HR可穿戴设备的有效性测试和报告的建议。此外,提供检查表以指导验证方案的制定和报告。这将确保制造商,消费者,医疗保健提供者和研究人员安全地使用可穿戴设备,并充分发挥其潜力。
    Assessing vital signs such as heart rate (HR) by wearable devices in a lifestyle-related environment provides widespread opportunities for public health related research and applications. Commonly, consumer wearable devices assessing HR are based on photoplethysmography (PPG), where HR is determined by absorption and reflection of emitted light by the blood. However, methodological differences and shortcomings in the validation process hamper the comparability of the validity of various wearable devices assessing HR. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables assessing HR by PPG. The recommendations were developed through the following multi-stage process: (1) a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, (2) an unstructured review of the wider literature pertaining to factors that may introduce bias during the validation of these devices and (3) evidence-informed expert opinions of the INTERLIVE Network. A total of 44 articles were deemed eligible and retrieved through our systematic literature review. Based on these studies, a wider literature review and our evidence-informed expert opinions, we propose a validation framework with standardised recommendations using six domains: considerations for the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. As such, this paper presents recommendations to standardise the validity testing and reporting of PPG-based HR wearables used by consumers. Moreover, checklists are provided to guide the validation protocol development and reporting. This will ensure that manufacturers, consumers, healthcare providers and researchers use wearables safely and to its full potential.
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  • 文章类型: Guideline
    消费者可穿戴设备和智能手机设备提供了一种可访问的手段来通过步数客观地测量身体活动(PA)。随着这项技术的日益普及,消费者,从业者和研究人员有兴趣利用这些设备作为跟踪和促进PA行为变化的手段。然而,虽然这些设备的接受度越来越高,许多消费设备的有效性尚未得到严格和透明的评估。迈向智能健康和福祉网络的身体活动评估(INTERLIVE)是六所大学和一个工业合作伙伴的欧洲联合倡议。该联盟成立于2019年,致力于制定最佳实践建议,以评估消费者可穿戴设备和智能手机的有效性。本专家声明提供了最佳实践的消费者可穿戴和智能手机步数计数器验证协议。使用两步过程来汇总数据并为开发最佳可行的验证方案奠定科学基础:(1)系统的文献综述和(2)对与可能引入因素有关的更广泛文献的其他搜索在这些设备的验证过程中。系统的文献综述过程确定了2897篇潜在文章,有85篇文章被认为符合最终数据集的条件。从合成数据中,我们确定了一组在设计和报告验证研究过程中需要考虑的六个关键领域:目标人群,标准度量,指标度量,验证条件,数据处理和统计分析。基于这六个领域,确定了一组感兴趣的关键变量,并开发了用于验证消费者可穿戴设备和智能手机计步器的\'基本\'和\'高级\'多级协议。INTERLIVE联盟建议在考虑验证任何消费者可穿戴或智能手机计步器时使用所提出的协议。已提供清单以指导验证方案的制定和报告。该网络还为今后的研究活动提供指导,强调迫切需要开发可行的替代“黄金标准”标准措施,以进行自由生活验证。遵守这些验证和报告标准将有助于确保方法和报告的一致性,促进消费者设备之间的比较。最终,这将确保这些设备被整合到标准的医疗保健中,消费者,从业者,行业和研究人员可以安全地使用这项技术,并充分发挥其潜力。
    Consumer wearable and smartphone devices provide an accessible means to objectively measure physical activity (PA) through step counts. With the increasing proliferation of this technology, consumers, practitioners and researchers are interested in leveraging these devices as a means to track and facilitate PA behavioural change. However, while the acceptance of these devices is increasing, the validity of many consumer devices have not been rigorously and transparently evaluated. The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives to develop best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice consumer wearable and smartphone step counter validation protocol. A two-step process was used to aggregate data and form a scientific foundation for the development of an optimal and feasible validation protocol: (1) a systematic literature review and (2) additional searches of the wider literature pertaining to factors that may introduce bias during the validation of these devices. The systematic literature review process identified 2897 potential articles, with 85 articles deemed eligible for the final dataset. From the synthesised data, we identified a set of six key domains to be considered during design and reporting of validation studies: target population, criterion measure, index measure, validation conditions, data processing and statistical analysis. Based on these six domains, a set of key variables of interest were identified and a \'basic\' and \'advanced\' multistage protocol for the validation of consumer wearable and smartphone step counters was developed. The INTERLIVE consortium recommends that the proposed protocol is used when considering the validation of any consumer wearable or smartphone step counter. Checklists have been provided to guide validation protocol development and reporting. The network also provide guidance for future research activities, highlighting the imminent need for the development of feasible alternative \'gold-standard\' criterion measures for free-living validation. Adherence to these validation and reporting standards will help ensure methodological and reporting consistency, facilitating comparison between consumer devices. Ultimately, this will ensure that as these devices are integrated into standard medical care, consumers, practitioners, industry and researchers can use this technology safely and to its full potential.
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  • 文章类型: Journal Article
    The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL).
    Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement.
    Cervical OPLL can cause various degrees of neurological symptoms, an it\'s thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article.
    In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.
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  • 文章类型: Journal Article
    Although drug-eluting stents are still the default interventional treatment of coronary artery disease, drug-coated balloons (DCBs) represent a novel alternative therapeutic strategy in certain anatomic conditions. The effect of DCBs is based on the fast and homogenous transfer of antiproliferative drugs into the vessel wall during single balloon inflation by means of a lipophilic matrix without the use of permanent implants. Although their use is established for in-stent restenosis of both bare-metal and drug-eluting stents, recent randomized clinical data demonstrate a good efficacy and safety profile in de novo small-vessel disease and high bleeding risk. In addition, there are other emerging indications (e.g., bifurcation lesions, large-vessel disease, diabetes mellitus, acute coronary syndromes). Because the interaction among the different delivery balloon designs, doses, formulations, and release kinetics of the drugs used is important, there seems to be no \"class effect\" of DCBs. On the basis of the amount of recently published data, the International DCB Consensus Group provides this update of previous recommendations summarizing the historical background, technical considerations such as choice of device and implantation technique, possible indications, and future perspectives.
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