2025年的方法HELPinKids&Adults和临床实践指南,用于减少疫苗接种期间的痛苦
Anna Taddio1,2,3, Vibhuti Shah4,5, C Meghan McMurtry6,7,8,9,10
1Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
The Clinical journal of pain
|March 12, 2026
概括
这份关于减少疫苗接种困境的指南更新使用了严格的方法,包括PICO和5P框架. 尽管证据基础增加了,但关于疫苗接种应急干预措施的研究质量仍然很低.
科学领域:
- 公共卫生 公共卫生
- 临床实践指南 临床实践指南
- 基于证据的医学 基于证据的医学
背景情况:
- 疫苗接种对公共卫生至关重要,但可能会给接种者带来痛苦.
- 以前的临床实践指南 (CPG) 旨在减少与疫苗接种相关的痛苦.
- 需要进行十年更新,以纳入新的证据和完善建议.
研究的目的:
- 更新2015年关于减少疫苗接种期间痛苦的CPG.
- 总结了指导方针开发的最新方法方法.
- 描述临床问题和指导方针所包含的研究.
主要方法:
- 准则的制定遵循了AGREE-II,GRADE,GIN和Cochrane框架.
- 临床问题是使用PICO和5P框架 (过程,程序,物理,药理,心理) 构建的.
- 进行了系统的文献搜索和偏见风险评估 (Cochrane工具);证据确定性被评为 (高,中等,低,非常低).
主要成果:
- 解决了47个临床问题,重点关注疫苗接种痛苦的过程,程序,物理,药理和心理方面.
- 痛苦是所有问题的关键结果.
- 从29301篇确定中包括201篇文章;大多数研究是在高收入国家进行的,专注于婴儿,并且具有偏见的高风险.
结论:
- 方法上的改进提高了更新指南的可用性.
- 疫苗应急干预的证据基础已经增长,但研究质量仍然很低.
- 更新的指南提供了可行的实践建议,尽管证据有限.
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