关于GOLD 2023建议在COPD管理中的临床应用的德尔菲共识:建议与临床实践有多么一致?
Antonio Anzueto1, Mark Cohen2, Andres L Echazarreta3
1University of Texas Health and South Texas Veterans Health Care System, San Antonio, TX, USA. anzueto@uthscsa.edu.
Pulmonary therapy
|December 19, 2023
概括
呼吸系统专家在2023年GOLD慢性阻塞性肺病 (COPD) 管理指南上达成了高度共识. 对B组和E组COPD的特定治疗选择需要进一步的证据.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床实践指南 临床实践指南
背景情况:
- 全球慢性阻塞性肺病倡议 (GOLD) 2023年报告为COPD管理提出了最新的建议.
- 评估专家的共识对于有效的临床实施这些指南至关重要.
研究的目的:
- 评估呼吸系统专家在GOLD 2023 COPD管理建议的临床应用方面达成一致的程度.
- 确定有关COPD最新定义,诊断和治疗策略的专家意见的共识和分歧领域.
主要方法:
- 德尔菲的一项研究涉及34名国际呼吸系统专家.
- 进行了两次在线调查和一次参与者会议,采集了73个问题的答案,使用0-9的利克特比例表.
- 建立了75%协议的共识门.
主要成果:
- 在大多数关于COPD定义和诊断的更新方面达成了共识.
- 对治疗建议观察到混合一致性:74%用于组E的双重支气管扩展剂,63%用于组B的三重治疗 (吸入皮质类固醇/长效β2激动剂/长效肌肉类受体对抗剂).
- 在资源有限的环境中,缺乏关于删除ICS/LABA作为初步选择的共识.
- 88%的专家表示在日常实践中使用GOLD建议.
结论:
- 德尔菲研究表明,在GOLD 2023报告的关键方面,包括COPD定义,诊断和预防的更新,专家们有强烈的共识.
- 需要进行进一步的研究,以加强GOLD报告的临床应用,特别是针对B组和E组COPD的基于病因型的管理和治疗选择.
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