Management of spontaneous pneumothorax - An American College of Chest Physicians Delphi Consensus Statement
Management of spontaneous pneumothorax - An American College of Chest Physicians Delphi Consensus Statement
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DOI：
10.1378/chest.119.2.590
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发表时间：
2001-02-01
期刊：
影响因子：
9.6
通讯作者：
Sahn, SA
中科院分区：
文献类型：
--
作者：
Baumann, MH;Strange, C;Sahn, SA
目的：提供明确的基于专家共识的建议，以管理急诊科和住院医院环境中的原发性和继发性自发性气胸成人。通过采用结构化问卷、适当性评分和共识评分以及德尔菲技术，明确了意见的使用。该指南旨在为制定气胸患者护理管理决策的医生提供相关信息。选项：观察、胸管放置、手术干预和放射成像的决策。结局：气胸消退的有效性、护理持续时间和患者耐受性以及气胸复发。证据：1967年至1999年1月的文献综述和德尔菲问卷分三次提交给多学科医生小组。指南制定小组通过协商一致确定了在制定德尔菲问卷时要考虑的相关结果。和成本：从指南实施中预期患者的受益、危害和成本的类型和幅度。建议：原发性或继发性气胸患者的管理决策不同，观察小气胸仅适用于原发性气胸。共识的程度不同的具体干预措施表明，但协议存在的一般原则的照顾。验证：建议是同行评议的医生专家和美国胸科医师学会（ACCP）的健康和科学政策委员会进行审查。实施：该指南的建议将出版印刷和电子形式的概要分发给患者和医疗保健提供者。本指南的内容将被纳入继续医学教育计划。
Objective: Provide explicit expert-based consensus recommendations for the management of adults with primary and secondary spontaneous pneumothoraces in an emergency department and inpatient hospital setting. The use of opinion was made explicit by employing a structured questionnaire, appropriateness scores, and consensus scores with a Delphi technique. The guideline was designed to be relevant to physicians who make management decisions for the care of patients with pneumothorax.Options: Decisions for observation, chest tube placement, surgical interventions, and radiographic imaging.Outcomes: Effectiveness of pneumothorax resolution, duration of and patient tolerance of care, and pneumothorax recurrence.Evidence: Literature review from 1967 to January 1999 and Delphi questionnaire submitted in three iterations to a multidisciplinary physician panel.Values: The guideline development group determined by consensus the relevant outcomes to be considered in developing the Delphi questionnaire.Benefits, harms, and costs: The type and magnitude of benefits, harms, and costs expected for patients from guideline implementation.Recommendations: Management decisions vary between patients with primary or secondary pneumothoraces, with observation of small pneumothoraces being appropriate only for primary pneumothoraces. The level of consensus varies regarding the specific interventions indicated, but agreement exists for the general principles of care.Validation: Recommendations were peer reviewed by physician experts and were reviewed by the American College of Chest Physicians (ACCP) Health and Science Policy Committee.Implementation: The guideline recommendations will be published in printed and electronic form with distribution of synopses for patients and health care providers. Contents of the guideline will be incorporated into continuing medical education programs.Sponsors: The ACCP.