德国制定胃肠道肿瘤围手术期管理国家指南的方法方案。

IF 2 3区 医学 Q2 ANESTHESIOLOGY
M A Willis, S Post, M Nothacker, M Follmann, T Langer, T O Vilz
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引用次数: 0

摘要

背景:腹部癌症手术的成功不仅取决于手术本身,还受到整个围手术期管理的影响。鉴于围手术期措施繁多,围手术期管理研究的数量也在不断增加,因此很难跟踪和提供循证围手术期管理。计划中的围手术期管理指南将对现有证据进行审查,并提出治疗建议:证据处理由 6 个工作组按照 8 个步骤进行:以 PICO 格式(1)起草指南问题后,进行系统文献检索(2),并由协调小组的两名独立审查员对所发现的记录进行筛选。随后,可能相关的文章全文将提供给工作组进行全文筛选 (3)。在生成研究结果汇总表(5)之前,将对所有拟纳入的文章进行方法学质量审查(4)。根据 GRADE 方法,先评估证据的可信度 (6),然后使用修改后的 GRADE 证据决策框架 (7),从证据中得出建议。最后,对所有建议进行汇编,并在指南小组内达成一致意见(8):讨论:指南是日常临床实践中治疗决策的基础,因此应基于最新的研究成果。然而,虽然原始研究和系统性综述的方法质量都经过严格审查,但指南的制定过程却往往难以理解。因此,预先确定方法的方案应具有透明度,并增强对建议的信心:该指南已在 AWMF(科学医学协会)指南注册处注册(088-010OL)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A methodological protocol for the development of a national guideline on perioperative management of gastrointestinal tumors in Germany.

Background: The success of abdominal cancer surgery depends not only on the surgery itself but is influenced by the overall perioperative management. Given the multitude of perioperative measures and the ever-increasing number of studies on perioperative management, it is difficult to keep track and provide evidence-based perioperative management. The planned guideline on perioperative management will review the existing evidence and derive treatment recommendations.

Methods: The processing of the evidence is carried out by 6 working groups according to an 8-step scheme: after drafting the guideline questions in PICO format (1), a systematic literature search is carried out (2), and the records found are screened by two independent reviewers from the coordination team. Subsequently, the full texts of the potentially relevant articles are made available to the working groups for full text screening (3). All articles to be included are reviewed for methodological quality (4) before summary of findings tables are generated (5). In line with the GRADE approach, confidence in the evidence is assessed (6) before a recommendation is derived from the evidence, using a modified GRADE Evidence to Decision Framework (7). Finally, all recommendations are compiled and agreed within the guideline group (8).

Discussion: Guidelines serve as foundation for therapy decisions in everyday clinical practice and should therefore be based on up-to-date research results. However, while primary studies and systematic reviews are critically reviewed for their methodological quality, the process of guideline development is often not comprehensible. A protocol with predefined methodology should therefore create transparency and strengthen confidence in the recommendations.

Trial registration: The guideline is registered in the AWMF (Association of the Scientific Medical Societies) Guideline Register (088-010OL).

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来源期刊
自引率
3.80%
发文量
55
审稿时长
10 weeks
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