中医药指南制订中共识法应用关键要素的定性研究

Exploring the Essential Factors of Applying the Consensus Methods in the Development of Traditional Chinese Medicine Guidelines: A Qualitative Interview

  • 摘要:
    目的 探索共识法在中医药指南制订中的关键要素,为改善共识的规范性和客观性提供方法学建议,为未来指南制订中规范应用共识法提供新思路。
    方法 采用半结构化定性访谈法,对指南牵头人、工作组及共识组进行访谈,探讨共识可信度的影响因素,以及对共识主体构成和共识过程的看法。
    结果 共访谈了26名专家,对访谈内容进行归纳和整理,形成212条编码,深化为5个领域,分别为组建共识组、患者参与、会议主持人、共识准备及共识影响因素;概括了组建共识组的3个基本步骤,以及共识法应用的17个基本考虑。
    结论 在指南制订过程中,建议增加共识前的方法学培训,方法学家应全程参与,鼓励专家合理看待分歧,重视指南制订方法及证据资料,公开共识组遴选过程、增加患者参与、管理和报告利益冲突,以减少偏倚,提高共识的透明性、可靠性和科学性。

     

    Abstract:
    Objective This study delves into the pivotal factors influencing the consensus process within traditional Chinese medicine guideline development, with the objective of augmenting the quality of this process through methodological recommendations aimed at elevating standardization.
    Methods Semi-structured qualitative interviews were used to interview guideline leaders, working groups and consensus groups to explore the pertinent elements impacting the credibility of consensus and gather insights into the constitution and progression of the consensus methodology.
    Results The study encompassed interviews with 26 participants, yielding 212 codes that were subsequently categorized into five domains: establishment of the consensus group, integration of patient participation, adeptness of the meeting moderator, preparation for consensus formulation, and overarching factors influencing consensus. The research distilled three fundamental phases for forming a consensus group and delineated 17 fundamental tenets for applying the consensus methodology.
    Conclusions In forthcoming guideline development endeavors, it is advisable to bolster methodological training ahead of the consensus process while ensuring comprehensive engagement of methodologists. Encouraging experts to navigate differences judiciously and prioritizing meticulous methodology and evidentiary groundwork are recommended. The process should involve openly disclosing the selection of consensus group members, heightening the involvement of patients, and effective management and disclosure of conflicts of interest. This collective approach helps curtail bias, enhance transparency, bolster reliability, and fortify the scientific rigor of consensus outcomes.

     

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