【摘要】：目的： 循證指南具有十分重要的臨床指導意義，但國內(nèi)開展此項工作較晚，成果略顯單薄。本文對國外可靠的指南開發(fā)及評價方法加以陳述，并詳細解讀不同國家兒童肺炎診治指南以及WHO等組織的報告，結(jié)合我國兒童臨床指南研究現(xiàn)狀，為規(guī)范我國兒童肺炎循證臨床指南的開發(fā)、制定提供參考。 方法: 關鍵詞檢索1993年—2013年ScienceDirect（全球最大的科學文獻全文數(shù)據(jù)庫，世界上公認的高品位學術期刊）、SpringerLink（全球最大的在線科學、技術、醫(yī)學領域?qū)W術平臺）、Web of Science、 EBSCO Medline。同時借助互聯(lián)網(wǎng)絡瀏覽NGC-美國國立臨床診療指南數(shù)據(jù)庫（www.guideline.gov）、WHO（www.who.org）等網(wǎng)站發(fā)布的相關信息。通過以上途徑獲得近20年世界范圍內(nèi)發(fā)布或發(fā)行的與兒童肺炎相關的指南、報告，以及指南評價工具等信息。 結(jié)果： 1.國際上已經(jīng)發(fā)展成熟并被廣泛接受的指南評價工具主要有兩種：AGREE與NICE，其中前者側(cè)重于指南的主要內(nèi)容與基本原則，后者主要偏重于指南證據(jù)的測評。此外，還有COGS-美國指南標準化會議（Conference on Guideline Standardization）等能夠?qū)χ改现贫ㄟM行約束與測評的客觀化標準。 2.近20年，在國際上發(fā)表的質(zhì)量較高的兒童肺炎臨床循證指南主要有5部，分別來自加拿大（1997年）、英國（2002年、2011年更新）、南非（2005年）、日本（2007年）、美國（2011年）。結(jié)論： 1.在短時間、低消耗的前提下，想要在我國快速開展循證指南的工作，盡早讓其發(fā)揮醫(yī)療保障作用，，修訂指南是最佳的選擇。 2.修訂已存在的臨床指南要有相應的或更高質(zhì)量的循證醫(yī)學證據(jù)，另外修訂的內(nèi)容也包括改善其質(zhì)量及適用性。 3.把其他國家指南中提及的高質(zhì)量證據(jù)轉(zhuǎn)變?yōu)槲覈R床推薦意見要充分考慮到地區(qū)和文化的差別。
[Abstract]:Objective: Evidence-based guidance is of great significance in clinical practice. This paper describes the development and evaluation methods of reliable guidelines in foreign countries, and interprets in detail the reports of different countries on the diagnosis and treatment of pneumonia in children, as well as the reports of organizations such as WHO, combined with the current research situation of clinical guidelines for children in China. To standardize the development of evidence-based clinical guidelines for pneumonia in children in China, to provide a reference. Methods: ScienceDirect (the world's largest full-text database of scientific literature and recognized high-grade academic journals in the world) from 1993 to 2013 (the largest online science, technology, medical field academic platform) was searched. At the same time, we use the Internet to browse the relevant information published by the NGC- National Clinical guidance Database (www.guideline.gov), WHO (www.who.org) and other websites. In the past 20 years, the guidelines, reports and evaluation tools related to children's pneumonia have been published or published worldwide. Results: 1. There are two kinds of guidelines and evaluation tools that have been developed and widely accepted in the world. The former focuses on the main contents and basic principles of the guide and the latter focuses on the evaluation of guide evidence. In addition, there are COGS-, the U. S. Conference on Standardization of guidelines, (Conference on Guideline Standardization) and others to guide the development of constraints and evaluation of the objective criteria. 2. In the past 20 years, there are mainly five Evidence-based guidelines for Children pneumonia published internationally, which are from Canada (1997), the United Kingdom (2002, 2011 update), South Africa (2005), Japan (2007), and the United States (2011). Conclusion: 1. In a short period of time, low consumption premise, if you want to quickly start the work of evidence-based guidance in our country, so that it can play a role in health care as soon as possible, the revised guidelines are the best choice. 2. 2. Revision of existing clinical guidelines requires appropriate or higher quality evidence-based medical evidence, as well as improvements in their quality and applicability. 3. Regional and cultural differences should be fully taken into account in translating the high quality evidence mentioned in other country guidelines into clinical recommendations in China.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R272

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