临床实践指南如何“保鲜”

临床实践指南是医疗实践的指导性文件, 及时修订的指南推荐意见对于指导医生进行临床决策具有重要意义和价值。因此, 指南应基于最新的研究证据, 形成对当前医疗实践的最佳推荐意见, 并保持与时俱进。本文针对指南修订的现状、方法、流程及存在的问题展开讨论, 提出指南修订最长周期为5年, 最短可以做到实时更新; 修订方法目前国内外无统一标准, 建议可参考本文提出的流程及RIGHT和CheckUp报告清单。此外, 本文就如何有效开展修订工作, 从指南管理者、制订者、研究者和使用者四个层面提出思考与建议。

How to Keep Clinical Practice Guidelines "Fresh"

Clinical practice guidelines are guiding documents in medical practices. Timely updated recommendations are important and valuable to guide physicians in making clinical decisions. Guidelines should be developed on the latest research evidence for the best recommendations in clinical practice and updated regularly to remain valid. Based on the discussion about the status quo, methods and procedures, and challenges of updating guidelines, our results showed that the longest update period is 5 years, and the shortest period can be constantly updated. Since there are no standardized methods for guideline updating, we proposed in this article the procedures for Chinese guideline developers, and recommended RIGHT and CheckUp as the reporting checklists. In addition, the related strategies and suggestions to effectively update guidelines were proposed for the guideline managers, developers, researchers, and users.