在巴基斯坦的背景下逐步发展甲状腺功能障碍治疗指南
Russell Seth Martins1, Sarah Nadeem2,3,4, Abeer Aziz1
1Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan.
BMC endocrine disorders
|March 21, 2024
概括
这项研究适应了巴基斯坦甲状腺功能障碍管理的国际指南,引入了两项修改,以降低患者成本和限制不必要的实验室测试. 这些新的临床实践指南将在资源有限的环境中优先考虑财务可访问性.
科学领域:
- 内分泌学 在内分泌学.
- 临床实践指南 临床实践指南
- 公共卫生 公共卫生
背景情况:
- 巴基斯坦的甲状腺功能障碍 (2.9%) 患病率是美国的两倍.
- 国际指南往往缺乏当地适用性和透明的方法.
- 巴基斯坦甲状腺功能障碍症的特定临床实践指南 (CPG) 的需要.
研究的目的:
- 根据巴基斯坦的背景,为甲状腺功能障碍管理开发全面的,高质量的CPG.
- 使用透明的方法调整现有的国际指导方针.
- 纳入当地卫生系统的需求和资源限制.
主要方法:
- 采用了渐进式发展的方法.
- 使用了2016年美国甲状腺协会指南作为来源CPG.
- 根据当地环境,建议被采纳,排除或调整.
主要成果:
- 从源指南中审查了124条建议.
- 通过了71个建议,排除了49个,并调整了4个.
- 两个关键的适应:合理使用肝功能测试与抗甲状腺药物和甲状腺状况测试后放射性治疗格雷夫斯病,专注于降低成本.
结论:
- 开发了针对巴基斯坦的甲状腺功能增强症CPG,其中有两个特定环境的修改.
- 修改优先考虑患者的财务状况,并限制在资源有限的环境中过度使用实验室测试.
- 需要进一步研究修改建议的成本效益和风险-收益.
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