患者指南制定方法(一)——患者指南概念的确立

Methodology for Developing Patient Guideline(1):The Concept of Patient Guideline

自患者版指南(patient versions of guidelines,PVG)概念被引入我国后,国内陆续发布了多部PVG。通过分析发现,国内外对于PVG概念的理解有较大差异,且产生该差异的原因未被合理地解释,使得指南制定者对PVG概念模糊不清,甚至出现错用现象。通过分析PVG产生的背景和目的、国内学者对PVG概念的理解,提出了患者指南(patient guideline,PG)一词,即在循证医学理念指导下,以患者关注的健康问题为中心,以当前可获得的最佳证据为基础制定的供患者使用的指南。PG的核心属性除了普通健康宣教材料所具备的“提供信息或进行教育”之外,还包括“提供推荐建议”和“辅助决策”属性,因此既包括了国际指南网所定义的PVG,也包含了“以患者为中心的指南”,即通过临床实践指南改编或者重新制定推荐意见所形成的临床实践指南。

Since the concept of patient versions of guidelines(PVGs)was introduced into China,several PVGs have been published in China,but we found that there is a big difference between the concept of PVG at home and abroad,and the reason for this difference has not been reasonably explained,which has led to ambiguity and even mis⁃application of the PVG concept by guideline developers.By analyzing the background and purpose of PVGs,and the understanding of the PVG concept by domestic scholars,we proposed the term patient guidelines(PGs).This refers to guidelines developed under the principles of evidence-based medicine,centered on health issues that concern patients,and based on the best available evidence,intended for patient use.Except for the general attribute of provid⁃ing information or education,which is typical of common health education materials,PGs also provide recommenda⁃tions and assist in decision-making,so PGs include both the patient versions of guidelines(PVG)as defined by the Guidelines International Network(GIN)and"patient-directed guidelines",i.e.clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.