对史蒂文斯-约翰逊综合征和表皮解的皮肤导向评分系统的开发:德尔菲共识练习
Margo Waters1, Allison Dobry2, Stephanie T Le3
1The Ohio State University College of Medicine, Columbus.
JAMA dermatology
|May 31, 2023
概括
专家皮肤科医生就表皮解 (EN) 皮肤病变的标准化术语和形态特征达成共识. 这项工作奠定了新的皮肤导向评分系统的基础,以改善EN评估.
科学领域:
- 皮肤病学 皮肤病学
- 临床信息学 临床信息学
- 患者安全 患者安全
背景情况:
- 目前对史蒂文斯-约翰逊综合征和表皮亡 (EN) 的评分系统主要关注预后,并发症和全身特征.
- 对EN病变的不一致的形态术语阻碍了标准化的评估和研究.
- 需要一种以皮肤为导向的评分系统来补充现有的预后工具.
研究的目的:
- 为了在EN病变的标准化术语上达成专家共识.
- 确定EN的形态进展和最受影响的部位.
- 开发一个新的框架,以皮肤为导向的评分系统,用于EN.
主要方法:
- 采用了使用RAND/UCLA适当性标准的Delphi共识过程.
- 54名皮肤病医院医生组成的核心组参加了两轮的共识建设.
- 寻求在术语,形态特征和EN参与的地点上达成协议.
主要成果:
- 达成共识,需要一种特定于皮肤的EN仪器.
- 最常受到影响的部位被确定为头部和部,胸部,上背部,眼膜粘膜和口腔粘膜.
- 关键的形态特征,包括白化红血,阴暗红血,形红血,囊泡/泡,脱皮和侵蚀,都被一致定义.
结论:
- 这一共识实践证实了对EN的标准化,面向皮肤的评分系统的必要性.
- 既定的命名法和定义的形态特征为一致的EN评估提供了基础.
- 这些发现有助于开发可靠的工具来评估EN的严重程度和特征.
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