WHO智慧指南：指南制订和实施的新方向

王琪; 罗旭飞; 王子君; 杨楠; 朱迪; 李哲玮; 辛鑫; 杨振华; 王玲; 史乾灵; 陈耀龙

doi:10.12290/xhyxzz.2023-0274

WHO智慧指南：指南制订和实施的新方向

doi: 10.12290/xhyxzz.2023-0274

王琪^{1, 2, 3},
罗旭飞⁴,
王子君⁴,
杨楠⁴,
朱迪⁵,
李哲玮⁵,
辛鑫⁶,
杨振华⁷,
王玲⁵,
史乾灵⁸,
陈耀龙^{3, 4, 5, 9, 10, 11, ,}

1.
麦克马斯特大学健康科学学院卫生研究方法、证据和影响系，加拿大汉密尔顿 L8S4L8
2.
麦克马斯特大学麦克马斯特卫生论坛，加拿大汉密尔顿 L8S4L8
3.
世界卫生组织指南实施与知识转化合作中心，兰州 730000
4.
兰州大学基础医学院循证医学中心，兰州 730000
5.
兰州大学公共卫生学院，兰州 730000
6.
匹兹堡大学电子与计算机工程系，美国宾夕法尼亚州匹兹堡 15217
7.
北京邮电大学信息光子学与光通信研究院，北京 100000
8.
兰州大学第一临床医学院，兰州 730000
9.
兰州大学健康数据科学研究院，兰州 730000
10.
兰州大学甘肃省循证医学与临床转化重点实验室，兰州 730000
11.
中国医学科学院循证评价与指南研究创新单元兰州大学基础医学院，兰州 730000

基金项目:

中央高校基本科研业务费专项资金 lzujbky-2021-ey13

详细信息

通讯作者:
陈耀龙, E-mail：chevidence@lzu.edu.cn

中图分类号: R181.2
计量
- 文章访问数: 316
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-07
- 录用日期: 2023-06-26
- 网络出版日期: 2023-07-10
- 刊出日期: 2023-07-30

WHO SMART Guidelines: A New Direction for Guideline Development and Implementation

WANG Qi^{1, 2, 3},
LUO Xufei⁴,
WANG Zijun⁴,
YANG Nan⁴,
ZHU Di⁵,
LI Zhewei⁵,
XIN Xin⁶,
YANG Zhenhua⁷,
WANG Ling⁵,
SHI Qianling⁸,
CHEN Yaolong^{3, 4, 5, 9, 10, 11
, ,}

1.
Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton L8S4L8, Canada
2.
McMaster Health Forum, McMaster University, Hamilton L8S4L8, Canada
3.
WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China
4.
Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
5.
School of Public Health, Lanzhou University, Lanzhou 730000, China
6.
Electrical and Computer Engineering Department, University of Pittsburgh, Pittsburgh, Pennsylvania 15217, USA
7.
Institute of Information Photonics and Optical Communications, Beijing University of Posts and Telecommunications, Beijing 100000, China
8.
The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
9.
Institute of Health Data Science, Lanzhou University, Lanzhou 730000, China
10.
Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
11.
Research Unit of Evidence-based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

Funds:

Fundamental Research Funds for the Central Universities lzujbky-2021-ey13

More Information

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

摘要

摘要: 世界卫生组织(World Health Organization，WHO)指南历经数十年的发展与革新，制订方法和质量均在不断完善。然而，常规指南的实施仍存在一些问题，包括从制订到实施的时间周期较长、推荐意见准确性和一致性可能受损以及部分国家支持指南改编和实施能力有限等。因此，指南的推荐意见无法达到预期效果。随着数字健康系统的发展，WHO及其成员国意识到数字化指南的重要性，推出了智慧指南。这一新方法可在数字时代加速循证指南的实施，提高其依从性和可实施性，改善卫生保健质量和人群健康结局。本文旨在介绍WHO智慧指南的背景、定义、框架和构成，并以产前保健智慧指南为例对其进行解读。
- 世界卫生组织 /
- 智慧指南 /
- 指南实施 /
- 数字健康
Abstract: The quality and methodology of guidelines developed by the World Health Organization (WHO) have been continuously improved after decades of development and reform. However, the implementation of conventional guidelines faces certain challenges, including lengthy timelines, the possible loss of accuracy and consistency of recommendations, and limited capacity of some countries to support guideline adaptation and implement. As a result, the expected effects of guideline recommendations may not be fully achieved. As many countries are investing heavily in digital health systems, both the WHO and its Member States have recognized the importance of digital implementation of guidelines and developed the SMART Guidelines. As a new approach, SMART Guidelines can accelerate the implementation of evidence-based recommendations in the digital age, enhance their compliance and implementability, and improve healthcare quality and population outcomes. This article aims to provide an overview of the background, definition, framework, and knowledge layers of the WHO SMART Guidelines, using antenatal care guidelines as an example for interpretation.
- World Health Organization /
- SMART Guidelines /
- guideline implementation /
- digital health
注释:

作者贡献：王琪、陈耀龙负责论文设计和构想；王琪、罗旭飞、王子君、杨楠负责论文初稿撰写；朱迪、李哲玮、辛鑫、杨振华、王玲、史乾灵参与论文修改；陈耀龙负责研究指导和论文审校。

利益冲突：所有作者均声明不存在利益冲突

HTML全文

表 1 WHO智慧指南的五个知识层及其框架

	知识层	内容	说明	举例(以产前保健智慧指南为例)
L1	叙述层(narrative)	叙述性指南(narrative guidelines)	循证指南推荐意见及相关实施文件	WHO积极孕期体验的产前保健推荐意见
L2	操作层(operational)	数字适配工具包(digital adaptation kits，DAKs)	针对可操作性和功能性需求的高层次(“人类可读”)且软件中立的开发工具	产前保健数字适配工具包
L3	机器可读层(machine readable)	机器可读的推荐意见(machine-readable recommendations)	结构性软件中立的规范、编译、术语、可操作性标准	基于标准的(HL7/FHIR)产前保健技术实施指导
L4	可执行文件层(executable)	参考应用程序和服务(reference applications and services)	能够执行可执行的静态算法和可交互的数字组件的软件，以提供可操作性和功能性需求	WHO产前保健数字模块(通用版本1.0)
L5	动态层(dynamic)	精准健康模型(precision health models)	可执行的动态算法，通过高级分析进行训练和优化以达到最优结局	(研发中)
HL7:健康七级国际组织; FHIR: 快速医疗保健互操作性资源

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参考文献(32)

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WHO智慧指南：指南制订和实施的新方向

doi: 10.12290/xhyxzz.2023-0274

通讯作者:
陈耀龙, E-mail：chevidence@lzu.edu.cn

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WHO SMART Guidelines: A New Direction for Guideline Development and Implementation

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

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留言板

WHO智慧指南：指南制订和实施的新方向

doi: 10.12290/xhyxzz.2023-0274

通讯作者: 陈耀龙, E-mail：chevidence@lzu.edu.cn

计量

出版历程

WHO SMART Guidelines: A New Direction for Guideline Development and Implementation

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

计量

出版历程

目录

通讯作者:
陈耀龙, E-mail：chevidence@lzu.edu.cn