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目的中国万古霉素治疗药物监测指南是我国首部基于GRADE系统制定的治疗药物监测指南。指南专家组于2014年12月21日举行推荐意见共识会,形成了14条推荐意见。本研究旨在了解中国万古霉素治疗药物监测指南推荐意见的科学性和可行性,以进一步修订推荐意见。方法对指南推荐意见进行独立外审,通过纸质问卷调查中级职称以上临床医师、临床药师和护师对14条推荐意见的赞同度,评价推荐意见的表述清楚程度和可行程度并收集其他方面的建议。基于外审结果,指南专家组开会讨论并修订推荐意见。结果共有来自4家医院、11个科室的40名临床医师、临床药师和护师参与外审工作。对推荐意见的总体赞成程度为70%,总体表述清楚程度为88%,总体可行程度为70%。其中,4条推荐意见赞成程度未超过50%,5条推荐意见可行程度未超过50%。此外,共收到165条主观建议。经指南专家组讨论,最终修订了8条推荐意见,其中删除4条推荐意见,合并2条推荐意见,局部修改2条推荐意见。结论本次外审工作在中国循证指南制定领域是一次有意义的探索与尝试,保证了更多利益相关方的参与,促进了推荐意见的明晰性和可行性。
Objective The guideline for the monitoring of vancomycin treatment in China is the first guide for the monitoring of therapeutic drugs in China based on the GRADE system. The guideline panel held a recommendation consensus meeting on December 21, 2014, forming 14 recommendations. The purpose of this study is to understand the scientific and feasibility of the recommended guidelines for monitoring vancomycin treatment in China so as to further revise the recommendations. Methods An independent external review was conducted on the recommendations of the guideline. The questionnaire survey was conducted on the degree of approval of 14 recommended opinions by clinicians, clinical pharmacists and nurses above the intermediate-level professional titles, to evaluate the clarity and feasibility of the recommendations and to collect other aspects Suggest. Based on the results of the external review, the guideline expert group meets to discuss and revise the recommendations. Results A total of 40 clinicians, clinical pharmacists and nurses from 4 hospitals and 11 departments participated in the external audit. The overall level of approving of the recommendation is 70%, the overall level of articulation is 88% and the overall practicability is 70%. Among them, four recommendations did not exceed 50% approval level, five recommendations did not exceed 50% viability. In addition, a total of 165 subjective suggestions have been received. After the discussion by the expert group, 8 final opinions were revised, including 4 suggestions, 2 recommended comments and 2 suggestions. Conclusion This review exercise is a meaningful exploration and attempt in the field of evidence-based guideline development in China, ensuring the participation of more stakeholders and promoting the clarity and feasibility of the recommendations.