评估NICE关于两个手术手术的指南
James Ryan1, James Piercy, Phil James
1Mapi Values Ltd, Bollington SK10 5JB, Cheshire, UK. james.ryan@mapivalues.com
Lancet (London, England)
|May 12, 2004
概括
美国国家卓越研究所 (NICE) 的指导显示,智牙切除和关节置换对智牙切除和关节置换的影响最小. 以前的趋势,而不是NICE建议,影响了提取率,关节假肢使用没有显著变化.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床指南 影响评估 临床指南
- 医疗保健政策评估 医疗保健政策评估
背景情况:
- 国家卫生和护理卓越研究所 (NICE) 提供关于临床程序和技术的指导.
- 评估临床指南对医疗保健实践的实际影响对于基于证据的政策至关重要.
研究的目的:
- 评估NICE指南对英格兰国家卫生服务中智慧牙切除和初级全关节置换手术的影响.
- 为了确定NICE指南是否对这些特定程序显著改变了临床行为.
主要方法:
- 利用了来自英国国家卫生服务医院的医院活动数据,这些医院在1997年至2002年间不断提交数据.
- 在引入NICE指南之前和之后,分析了智慧牙切除和初级全关节置换的趋势.
主要成果:
- 分析表明,NICE指导并不是观察到智慧牙拔除的下降趋势的主要驱动因素;之前的指导是更可能的因素.
- 在发布NICE全关节置换指南后,没有发现非水泥关节假肢使用的显著变化.
结论:
- 在研究期间,NICE指南对智拔除和初级全关节置换手术的临床实践的影响有限.
- 这些发现表明,其他因素,可能包括先前存在的趋势或早期的建议,在塑造这些程序的实践中发挥了更重要的作用.
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