临床实践指南中的复杂性决定因素:Delphi研究,包括指南开发者和实施者的观点
Marleen Corremans1,2, Zachary Munn3, Sanne Peters4
1JBI Belgium: A JBI Centre of Excellence, Leuven, Belgium.
JBI evidence implementation
|March 10, 2025
概括
本研究确定了十个关键因素,影响了开发和实施基于证据的临床实践指南的复杂性. 了解这些决定因素对于在医疗保健中有效采用指南至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床实践指南 临床实践指南
- 干预科学 干预科学
背景情况:
- 医学研究委员会 (MRC) 框架指导复杂干预措施的开发和实施.
- 基于证据的临床实践指南 (CPG) 提供了采用干预措施的建议.
- 影响CPG复杂性的因素需要详细研究.
研究的目的:
- 描述基于证据的临床实践指南的开发和实施中的复杂性决定因素.
- 评估MRC复杂干预要素对CPG的适用性.
主要方法:
- 成立了一个由16名参与者组成的工作组,包括辩论小组和Delphi小组.
- 辩论小组确定了MRC复杂干预定义的关键要素,以确定指南的适用性.
- 德尔菲小组评估了这些要素与CPG复杂性的相关性.
主要成果:
- 在两轮德尔菲会议之后,就定义指导方针复杂性方面的十个要素达成共识.
- 对于已识别的元素,评级者之间的可靠性在0.83到1.00之间.
- 没有就排除任何特定元素达成协议.
结论:
- 越来越多的组件,设置,行为和利益相关者有助于指导方针的复杂性.
- 指南与临床现实之间的差距,教育差异,协作水平,变化范围,证据水平和工作负载也决定了复杂性.
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