质量指标开发,以解决无效食道运动的方法:修改后的德尔菲研究
Afrin N Kamal1, Priya Kathpalia2, David A Leiman3
1Division of Gastroenterology and Hepatology, Stanford University, Redwood City.
Journal of clinical gastroenterology
|January 16, 2024
概括
使用专家的共识,开发了两种不有效的食道运动 (IEM) 的质量指标. 这些指标旨在改善对这种常见的计量力测定结果的性能跟踪,尽管需要进一步的研究.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 改善医疗质量 改善医疗质量
背景情况:
- 无效食道运动 (IEM) 在高达20%的患者中通过高分辨率计量 (HRM) 诊断出来.
- IEM的临床意义和最佳管理仍然定义不完善.
- 目前的诊断标准是基于芝加哥分类.
研究的目的:
- 开发和建立基于共识的对无效食道运动 (IEM) 的质量指标.
- 为评估和改善IEM的临床管理提供一个框架.
- 确定需要对IEM进行进一步研究的领域.
主要方法:
- 使用使用RAND/UCLA适当性方法的修改后的Delphi方法.
- 根据现有文献,制定了12个建议的质量指标陈述.
- 十位食道专家参与了3轮的代过程,包括独立和盲目的评分和虚拟讨论.
主要成果:
- 专家们在IEM的两个质量指标上达成了全面的共识.
- 四个指标达成部分协议,一个指标没有达成协议.
- 在评估IEM的临床相关性和管理GERD方面达成了共识,在促进运动的药物方面存在分歧,在手术规划方面有不同的看法.
结论:
- 一个强大的方法成功地确定了IEM的两个质量指标.
- 这些指标可以标准化在人力资源管理上识别的IEM的绩效跟踪.
- 该研究强调了IEM管理的挑战以及对其临床重要性进行进一步调查的必要性.
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