制定肠外肠内营养指南和规范的“指南”:方法学、推荐意见分级与通过程序

Guidelines for Establishing CSPEN Clinical Guidelines:Methodology,Recommendation Grading and Procedures

中华医学会肠外肠内营养学分会自2004年12月成立,即开始了合理规范应用肠外肠内营养学的有关工作。在中华医学会正副会长的指导下,2005年4月启动了肠外肠内营养“指南”和“规范”的制定工作。参与“指南”和“规范”编写的52位专家来自多个学科,也包括部分基层医院医护人员;共组成8个编写组,分别完成“指南”(草案)相应部分和部分“规范”的内容。2006年5～8月,有7个编写组先后召开了8次总论和各论的“共识”和“规范”会议,就本版的编撰结构、证据分级和推荐意见分级体系、文献检索策略等方法学问题展开讨论,确定了工作方案,各自召开“共识会议”进行讨论,完成相应的文件。通过确定检索策略、入选标准和特定关键词,采用系统化的文献检索,收集指南推荐意见相关支持证据。按照证据级别,参照国际标准并结合本领域的国内情况,制定推荐意见分级体系。分会的“指南”(草案)和“规范”(草案)由各个“共识工作组”相互配合完成。达成“共识”后和最终定稿前,按“议事规则”对“指南”(草案)和“规范”(草案)进行投票表决。“肠外肠内营养临床指南和操作规范”力图反映目前国内外肠外肠内营养支持的最新证据,为临床医师、护理工作者、营养师和患者在特定临床条件下制定和实行肠外肠内营养支持方案提供帮助,并为卫生政策的制定者提供决策依据。由于内容宽广,部分内容欠缺甚多,有待今后补充。

Chinese Society of Parenteral and Enteral Nutrition （CSPEN） ＂Clinical Guidelines on Parenteral and Enteral Nutrition＂ was systematically established between December 2004 and July 2006. Fifty two experts from multiple disciplines formed eight drafting groups to create the documents. The guidelines were based on clinical evidences gathered systematically. All these evidences were reviewed by expert groups and graded. Taking into consideration factors such as accuracy, availability and accessibility, and consulting international standards from ESPEN, ASPEN, JSPEN, the guideline development committees made the recommendation for the grading system. Each part of guidelines was drafted cooperatively. From May to August, 2006, 7 groups launched 8 ＂Guidelines＂ ＆ ＂SOP＂ meetings and totally 52 experts attended these meetings. To reach consensus, the final draft will be submitted to the CSPEN guideline working conference for discussion and adapted by vote. The process will be governed by principles of fairness and efficiency. CSPEN Guideline of Parenteral and Enteral Nutrition aims to reflect the best clinical evidences in the field. It helps physicians, nurses, nutritionists and patients in making nutritional decisions under specific clinical conditions. It also provide scientific basis for decision-makers in establishing medical practice policies.