American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 1
American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 1
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DOI：
10.1002/art.41301
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发表时间：
2020-06-05
影响因子：
13.3
通讯作者：
Saag, Kenneth G.
中科院分区：
文献类型：
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作者：
Mikuls, Ted R.;Johnson, Sindhu R.;Saag, Kenneth G.
目的 为风湿病医生在 2019 年冠状病毒病 (COVID-19) 大流行的背景下管理成人风湿病提供指导。 方法 召集了一个由来自北美的 10 名风湿病学家和 4 名传染病专家组成的工作组。整理了临床问题，并迅速生成并传播了证据报告。使用修改后的德尔菲流程对问题和起草的陈述进行审查和评估。其中包括 2 轮通过电子邮件进行的异步匿名投票以及 3 场与整个小组一起进行的网络研讨会。工作组成员使用 1-9 分的评分系统对声明草案的同意程度进行投票，并根据投票的分散程度确定共识程度为低、中或高。为了获得批准，中位票数需要达到预定的一致水平（中位值 7-9、4-6 和 1-3 分别定义为同意、不确定或不同意），并具有中等或高度的共识。结果 工作组批准了 77 项初步指导声明：36 项为中等共识，41 项为高度共识。将这些内容合并起来，形成了 25 项最终指导声明。 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且文献不断发展，本指南作为“动态文件”呈现，并且预计未来会更新。
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 2 rounds of asynchronous anonymous voting by e-mail and 3 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 The task force approved 77 initial guidance statements: 36 with moderate and 41 with high consensus. These were combined, resulting in 25 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.