值得信賴的臨床實作指引

Clinical Practice Guidelines We Can Trust

孫穆乾(Mu-Chien Sun)

《台灣醫學》 22卷1期 (2018/01) Pp. 97-101

https://doi.org/10.6320/FJM.201801_22(1).0011

摘要

臨床實作指引有多重的功能，除了可減少照護差異，提升照護品質，也會影響病人的權益和健康政策的制定。隨著數目的增加，臨床實作指引參差不齊的品質開始被警覺，並非所有的臨床實作指引都是可被信賴的。評價臨床實作指引的方法，以及建立可被信賴的臨床實作指引的標準，便被提出，這些發展已逐漸影響指引的建立方式。本文藉由回顧過去與最近的轉變，讓相關者更能掌握臨床實作指引發展轉移中的典範。

關鍵字

指引 ； 指引為主題 ； 實作指引 ； 實作指引為主題

並列摘要

Clinical practice guidelines play roles in reducing discrepancy among clinical cares, improving care quality, protecting patients' right, and health policy making. Attention has been paid to the quality of accumulating clinical practice guidelines. Clinical practice guidelines may not be trustworthy. Appraisal tools and standards for developing trustworthy guidelines are proposed to ensure quality of clinical practice guidelines. The purpose of this article is to review the shifting paradigm in developing clinical practice guidelines.

並列關鍵字

guideline ； guidelines as topic ； practice guideline ； practice guidelines as topic

參考文獻

Murad MH: Clinical practice guidelines: A primer on development and dissemination. Mayo Clin Proc 2017;92:423-33.

Woolf SH, Grol R, Hutchinson A, et al: Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ 1999;318: 527-30.

AGREE Collaboration: Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 2003;12:18-23.

Hoffmann-Eßer W, Siering U, Neugebauer EAM, et al: Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments. PLoS ONE 2017;12: e0174831.

Hu LT: Lyme disease. Ann Intern Med 2016;164:ITC65-ITC80.