儿童肺炎国内外循证指南临床证据评价分析及沿革研究
发布时间：2018-09-14 12:27
【摘要】：目的： 循证指南具有十分重要的临床指导意义，但国内开展此项工作较晚，成果略显单薄。本文对国外可靠的指南开发及评价方法加以陈述，并详细解读不同国家儿童肺炎诊治指南以及WHO等组织的报告，结合我国儿童临床指南研究现状，为规范我国儿童肺炎循证临床指南的开发、制定提供参考。 方法: 关键词检索1993年—2013年ScienceDirect（全球最大的科学文献全文数据库，世界上公认的高品位学术期刊）、SpringerLink（全球最大的在线科学、技术、医学领域学术平台）、Web of Science、 EBSCO Medline。同时借助互联网络浏览NGC-美国国立临床诊疗指南数据库（www.guideline.gov）、WHO（www.who.org）等网站发布的相关信息。通过以上途径获得近20年世界范围内发布或发行的与儿童肺炎相关的指南、报告，以及指南评价工具等信息。 结果： 1.国际上已经发展成熟并被广泛接受的指南评价工具主要有两种：AGREE与NICE，其中前者侧重于指南的主要内容与基本原则，后者主要偏重于指南证据的测评。此外，还有COGS-美国指南标准化会议（Conference on Guideline Standardization）等能够对指南制定进行约束与测评的客观化标准。 2.近20年，在国际上发表的质量较高的儿童肺炎临床循证指南主要有5部，分别来自加拿大（1997年）、英国（2002年、2011年更新）、南非（2005年）、日本（2007年）、美国（2011年）。结论： 1.在短时间、低消耗的前提下，想要在我国快速开展循证指南的工作，尽早让其发挥医疗保障作用，，修订指南是最佳的选择。 2.修订已存在的临床指南要有相应的或更高质量的循证医学证据，另外修订的内容也包括改善其质量及适用性。 3.把其他国家指南中提及的高质量证据转变为我国临床推荐意见要充分考虑到地区和文化的差别。
[Abstract]:Objective: Evidence-based guidance is of great significance in clinical practice. This paper describes the development and evaluation methods of reliable guidelines in foreign countries, and interprets in detail the reports of different countries on the diagnosis and treatment of pneumonia in children, as well as the reports of organizations such as WHO, combined with the current research situation of clinical guidelines for children in China. To standardize the development of evidence-based clinical guidelines for pneumonia in children in China, to provide a reference. Methods: ScienceDirect (the world's largest full-text database of scientific literature and recognized high-grade academic journals in the world) from 1993 to 2013 (the largest online science, technology, medical field academic platform) was searched. At the same time, we use the Internet to browse the relevant information published by the NGC- National Clinical guidance Database (www.guideline.gov), WHO (www.who.org) and other websites. In the past 20 years, the guidelines, reports and evaluation tools related to children's pneumonia have been published or published worldwide. Results: 1. There are two kinds of guidelines and evaluation tools that have been developed and widely accepted in the world. The former focuses on the main contents and basic principles of the guide and the latter focuses on the evaluation of guide evidence. In addition, there are COGS-, the U. S. Conference on Standardization of guidelines, (Conference on Guideline Standardization) and others to guide the development of constraints and evaluation of the objective criteria. 2. In the past 20 years, there are mainly five Evidence-based guidelines for Children pneumonia published internationally, which are from Canada (1997), the United Kingdom (2002, 2011 update), South Africa (2005), Japan (2007), and the United States (2011). Conclusion: 1. In a short period of time, low consumption premise, if you want to quickly start the work of evidence-based guidance in our country, so that it can play a role in health care as soon as possible, the revised guidelines are the best choice. 2. 2. Revision of existing clinical guidelines requires appropriate or higher quality evidence-based medical evidence, as well as improvements in their quality and applicability. 3. Regional and cultural differences should be fully taken into account in translating the high quality evidence mentioned in other country guidelines into clinical recommendations in China.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R272
本文编号：2242711
[Abstract]:Objective: Evidence-based guidance is of great significance in clinical practice. This paper describes the development and evaluation methods of reliable guidelines in foreign countries, and interprets in detail the reports of different countries on the diagnosis and treatment of pneumonia in children, as well as the reports of organizations such as WHO, combined with the current research situation of clinical guidelines for children in China. To standardize the development of evidence-based clinical guidelines for pneumonia in children in China, to provide a reference. Methods: ScienceDirect (the world's largest full-text database of scientific literature and recognized high-grade academic journals in the world) from 1993 to 2013 (the largest online science, technology, medical field academic platform) was searched. At the same time, we use the Internet to browse the relevant information published by the NGC- National Clinical guidance Database (www.guideline.gov), WHO (www.who.org) and other websites. In the past 20 years, the guidelines, reports and evaluation tools related to children's pneumonia have been published or published worldwide. Results: 1. There are two kinds of guidelines and evaluation tools that have been developed and widely accepted in the world. The former focuses on the main contents and basic principles of the guide and the latter focuses on the evaluation of guide evidence. In addition, there are COGS-, the U. S. Conference on Standardization of guidelines, (Conference on Guideline Standardization) and others to guide the development of constraints and evaluation of the objective criteria. 2. In the past 20 years, there are mainly five Evidence-based guidelines for Children pneumonia published internationally, which are from Canada (1997), the United Kingdom (2002, 2011 update), South Africa (2005), Japan (2007), and the United States (2011). Conclusion: 1. In a short period of time, low consumption premise, if you want to quickly start the work of evidence-based guidance in our country, so that it can play a role in health care as soon as possible, the revised guidelines are the best choice. 2. 2. Revision of existing clinical guidelines requires appropriate or higher quality evidence-based medical evidence, as well as improvements in their quality and applicability. 3. Regional and cultural differences should be fully taken into account in translating the high quality evidence mentioned in other country guidelines into clinical recommendations in China.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R272
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本文编号：2242711
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