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部疼痛患者潜在严重病理的红旗:临床实践指南的系统审查
Daniel Feller1,2, Alessandro Chiarotto2, Bart Koes2,3
1Provincial Agency for Health of the Autonomous Province of Trento, Trento - Italy.
临床实践指南显示,对于严重的部疼痛病理的红旗,几乎没有共识. 大多数建议缺乏强有力的证据,专家意见是主要支持.
科学领域:
- 临床实践指南 临床实践指南
- 系统审查是系统的审查.
- 基于证据的医学 基于证据的医学
背景情况:
- 部疼痛是一种常见的疾病,具有潜在的严重潜在病理.
- 临床实践指南旨在标准化诊断和管理.
- 识别严重疾病需要精确的查工具,如红旗.
研究的目的:
- 系统地审查临床实践指南,针对部疼痛中的红旗.
- 评估在指南中对红旗建议的共识.
- 调查这些建议的证据基础.
主要方法:
- 在MEDLINE,EMBASE和PEDro系统搜索指南.
- 包括关于特定和非特定部疼痛的指导方针.
- 采用了引用跟踪,专家咨询和数据库搜索.
主要成果:
- 包括29条指导方针,确定了各种严重病理的114个红旗.
- 在指南之间发现了非常低的一致性 (Fleiss' kappa的中位数为0).
- 建议主要基于专家意见,缺乏共识.
结论:
- 在严重的部疼痛病理方面,关于红旗的共识显著缺乏.
- 目前的证据有限,大多数红旗都是基于专家意见的.
- 推加拿大C-脊柱规则用于查创伤后骨折.
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