Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
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DOI：
10.1378/chest.11-2288
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发表时间：
2012-02-01
期刊：
影响因子：
9.6
通讯作者：
Schuenemann, Holger J.
中科院分区：
文献类型：
--
作者：
Guyatt, Gordon H.;Norris, Susan L.;Schuenemann, Holger J.
背景资料：为了制定抗血栓治疗和血栓预防，第9版艾德：ACCP循证临床实践指南（AT 9），美国胸科医师学会（ACCP）召集了一个由临床专家、信息科学家、决策科学家、系统评价和指南方法学家组成的专家组。临床领域被指定为文章，并且没有重要的知识或经济利益冲突的方法学家领导每篇文章的小组。只有没有重大利益冲突的小组成员才参与提出建议。小组成员指定了每个临床问题的人群、干预和替代方案以及结局，并定义了合格研究的标准。小组成员和一个独立的循证实践中心执行相关研究的系统搜索和评估的证据，并在资源和证据允许的情况下，他们创建了标准化的表格，目前的质量，在一个透明的fashion.Results的证据和关键结果：一个或多个建议涉及到每个特定的临床问题，每个建议是明确的基础证据。关于证据质量和建议强度的判断是基于建议、评估、发展和评价工作组的等级制定的方法。小组成员构建了描述相关健康状态的情景，并基于对患者价值和抗血栓治疗偏好相关证据的额外系统性综述，对与这些状态相关的负效用进行了评级。这些评级指导了建议背后的价值和偏好决定。每个专题小组都确定了资源分配问题特别重要的问题，经济分析专家为这些问题提供了额外的搜索和指导。AT 9方法学反映了当前循证临床实践指南开发的科学，依赖于高质量的系统性综述、单个研究质量评估的标准化流程和大量证据，将证据转化为建议的明确程序，披露财务和知识上的利益冲突，然后对披露的冲突进行管理，以及广泛的同行审查。胸部2012; 141（2）（增刊）：53 S-70 S
Background: To develop the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: ACCP Evidence-Based Clinical Practice Guidelines (AT9), the American College of Chest Physicians (ACCP) assembled a panel of clinical experts, information scientists, decision scientists, and systematic review and guideline methodologists.Methods: Clinical areas were designated as articles, and a methodologist without important intellectual or financial conflicts of interest led a panel for each article. Only panel members without significant conflicts of interest participated in making recommendations. Panelists specified the population, intervention and alternative, and outcomes for each clinical question and defined criteria for eligible studies. Panelists and an independent evidence-based practice center executed systematic searches for relevant studies and evaluated the evidence, and where resources and evidence permitted, they created standardized tables that present the quality, of the evidence and key results in a transparent fashion.Results: One or more recommendations relate to each specific clinical question, and each recommendation is clearly linked to the underlying body of evidence. judgments regarding the quality of evidence and strength of recommendations were based on approaches developed by the Grades of Recommendations, Assessment, Development, and Evaluation Working Group. Panel members constructed scenarios describing relevant health states and rated the disutility associated with these states based on an additional systematic review of evidence regarding patient values and preferences for antithrombotic therapy,. These ratings guided value and preference decisions underlying the recommendations. Each topic panel identified questions in which resource allocation issues were particularly important and, for these issues, experts in economic analysis provided additional searches and guidance.Conclusions: AT9 methodology reflects the current science of evidence-based clinical practice guideline development, with reliance on high-quality, systematic reviews, a standardized process for quality assessment of individual studies and the body of evidence, an explicit process for translating the evidence into recommendations, disclosure of financial as well as intellectual conflicts of interest followed by management of disclosed conflicts, and extensive peer review. CHEST 2012; 141(2)(Suppl):53S-70S