1.中国中医科学院中医临床基础医学研究所,北京市东城区东直门内南小街16号,100700
2.北京中医药大学中医学院
3.中国中医科学院针灸研究所
4.北京中医药大学护理学院
5.广东省中医院
6.香港大学深圳医院
7.复旦大学护理学院
8.山东中医药大学附属医院
9.厦门大学第一附属医院
liujp@bucm.edu.cn
收稿:2023-11-07,
修回:2024-08-12,
纸质出版:2024-11-02
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晏利姣,梁宁,史楠楠等.患者指南制定方法(二)——流程与方法[J].中医杂志,2024,65(21):2194-2198.
YAN Lijiao,LIANG Ning,SHI Nannan,et al.Methodology for Developing Patient Guideline (2):Process and Methodology[J].Journal of Traditional Chinese Medicine,2024,65(21):2194-2198.
晏利姣,梁宁,史楠楠等.患者指南制定方法(二)——流程与方法[J].中医杂志,2024,65(21):2194-2198. DOI: 10.13288/j.11-2166/r.2024.21.005.
YAN Lijiao,LIANG Ning,SHI Nannan,et al.Methodology for Developing Patient Guideline (2):Process and Methodology[J].Journal of Traditional Chinese Medicine,2024,65(21):2194-2198. DOI: 10.13288/j.11-2166/r.2024.21.005.
目前患者指南(patient guideline,PG)的制定流程与方法差异较大,缺乏系统、规范的指导。结合对PG制定者的经验访谈,梳理现有临床实践指南推荐意见改编和制定的相关方法学路径,并组织专家达成共识,最终提出PG制定流程与方法指导建议。PG的制定总体可分为准备阶段、构建阶段和完成阶段,但具体步骤根据不同PG的制定模式有所差异。模式一的制定流程与国际指南网所提供的患者版指南制定流程基本一致,即组建团队、筛选推荐意见、撰写指南、用户测试与反馈、审批和传播。制定者在准备阶段还应首先确定将该临床实践指南转译成患者版本的必要性及范围。模式二在常规临床实践指南制定流程(组建团队,确定PG的范围,检索、评价和整合证据,形成推荐意见,撰写指南,专家评审)的基础上增加用户体验与反馈的环节。基于不同模式梳理PG的制定流程与方法,并介绍PG制定的具体方法,包括如何确定临床问题、如何基于现有临床实践指南形成推荐意见等,以期为指南制定者及相关研究者提供参考。
At present, the process and methodology of patient guidelines (PGs) development varies greatly and lacks systematic and standardised guidance. In addition to the interviews with PG developers, we have sorted out the relevant methodology for the adaptation and development of existing clinical practice guideline recommendations and facilitated expert deliberations to achieve a consensus, so as to finally put forward a proposal for guidance on the process and methodology for the development of PGs. The development of PGs can be divided into the preparation stage, the construction stage, and the completion stage in general, but the specific steps vary according to the different modes of development of PGs. The development process of Model 1 is basically the same as the patient version of the guideline development process provided by the International Guidelines Network, i.e., team formation, screening of recommendations, guideline drafing, user testing and feedback, approval and dissemination. The developer should also first determine the need for and scope of translating the clinical practice guideline into a patient version during the preparation phase. Model 2 adds user experience and feedback to the conventional clinical practice guideline development process (forming a team, determining the scope of the PG, searching, evaluating and integrating evidence, forming recommendations, writing the guideline, and expert review). Based on the different models, we sort out the process and methods of PG development and introduce the specific methods of PG development, including how to identify the clinical problem and how to form recommendations based on the existing clinical practice guidelines, with a view to providing reference for guideline developers and related researchers.
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