American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 2
American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 2
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DOI：
10.1002/art.41437
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发表时间：
2020-07-30
影响因子：
13.3
通讯作者：
Saag, Kenneth G.
中科院分区：
文献类型：
--
作者：
Mikuls, Ted R.;Johnson, Sindhu R.;Saag, Kenneth G.
目的在新冠肺炎大流行的背景下，为风湿科提供者提供成人风湿病的管理指导。方法召集一个由10名风湿科医生和4名来自北美的传染病专家组成的工作组。对临床问题进行了整理，并迅速生成和分发了一份证据报告。使用改进的德尔菲法对问题和起草的声明进行了审查和评估。这包括通过电子邮件和整个小组的网络研讨会进行异步匿名投票。特别工作组成员使用1-9分数字计分系统对声明草案进行了投票，并根据选票的分散程度确定共识为低、中或高。对于批准，中位数票数需要满足预定义的一致水平(7-9、4-6和1-3的中位数分别定义为一致、不确定性或不一致)，并具有中等或高水平的共识。结果到目前为止，工作队已批准了80项指导声明：36项为中度，44项为高度共识。这些综合在一起，产生了27份最终指导声明。结论提供这些指导声明是为了在当前大流行期间促进最佳护理。然而，鉴于现有证据水平较低和文献发展迅速，本指南是作为一份“活文件”提出的，预计未来会有更新。
Objective To provide guidance to rheumatology providers on the management of adult rheumatic disease in the context of the coronavirus disease 2019 (COVID-19) pandemic. Methods A task force, including 10 rheumatologists and 4 infectious disease specialists from North America, was convened. Clinical questions were collated, and an evidence report was rapidly generated and disseminated. Questions and drafted statements were reviewed and assessed using a modified Delphi process. This included asynchronous anonymous voting by e-mail and webinars with the entire panel. Task force members voted on agreement with draft statements using a 1-9-point numerical scoring system, and consensus was determined to be low, moderate, or high based on the dispersion of votes. For approval, median votes were required to meet predefined levels of agreement (median values of 7-9, 4-6, and 1-3 defined as agreement, uncertainty, or disagreement, respectively) with either moderate or high levels of consensus. Results To date, the task force has approved 80 guidance statements: 36 with moderate and 44 with high consensus. These were combined, resulting in 27 final guidance statements. Conclusion These guidance statements are provided to promote optimal care during the current pandemic. However, given the low level of available evidence and the rapidly evolving literature, this guidance is presented as a "living document," and future updates are anticipated.