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World Organization of Family Doctors (Wonca) Forum, Beijing, 2006 William K. Dolen, MD

World Organization of Family Doctors (Wonca) Forum, Beijing, 2006 William K. Dolen, MD Medical College of Georgia, Augusta. Guidelines for Evaluation and Management of Respiratory Diseases 呼吸道疾病的评定和处理指南. GARD 全球 防慢性呼吸疾病联盟.

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World Organization of Family Doctors (Wonca) Forum, Beijing, 2006 William K. Dolen, MD

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  1. World Organization of Family Doctors (Wonca) Forum, Beijing, 2006 William K. Dolen, MD Medical College of Georgia, Augusta Guidelines for Evaluation and Management of Respiratory Diseases 呼吸道疾病的评定和处理指南

  2. GARD 全球防慢性呼吸疾病联盟 • Working towards the common goal of fighting chronic respiratory diseases 针对向慢性呼吸病斗争的一般目标的工作 • Identifying problems 确认问题 • Promoting solutions 推动解决 • Coordinating activities 协调活动 • Sharing expertise; encouraging and facilitating information exchange 参与的专家；鼓励支持信息交流 http://www.who.int/respiratory/gard/en/

  3. Shared expertise 技术共享 • Throughout the world, physician groups have developed “guidelines” for the diagnosis and management of respiratory disease 全世界的医生组织都制订了呼吸病诊断治疗指南 • These guidelines are mostly evidence-based 这些指南大多为循证性 • Most are available from the World-Wide Web 大多数可从全世界范围的网络上找到

  4. Advantages of guidelines 指南的优点 • Guidelines reflect a consensus of many experts on various non-controversial and controversial topics 反映许多专家在各种无争议/有争议领域的一致意见 • Evidence-based 循证性 • The authors of guidelines have done a very detailed review and analysis of published literature 作者对已出版的文献做了详细的回顾和分析 • Many guidelines have been studied prospectively to verify that they are appropriate for use 一些前瞻性研究已证明其实用性 • Some of the guidelines have international acceptance 有些已被许多国家接受

  5. Disadvantages of guidelines指南的不足 • Since guidelines are consensus recommendations, they are not appropriate for all patients 指南为共性的推荐内容，不一定适用于所有患者 • Guidelines are not a substitute for clinical thinking 指南不能代替临床思维 • Guidelines must be regularly updated to remain useful; physicians must be kept aware of updates 医生应意识到指南必须经常性修改，保持先进与实用 • Guidelines differ from country to country, reflecting different practice styles不同国家有适合本国服务方式的指南

  6. Examples – 1例-1 • Global Initiative for Asthma (GINA)哮喘全球行动 • http://www.ginasthma.org • Global Initiative for chronic Obstructive Lung Disease (GOLD)慢阻肺全球行动 • http://www.goldcopd.org • Allergic Rhinitis and its Impact on Asthma (ARIA) • http://www.whiar.org过敏性鼻炎及其对哮喘的威胁

  7. Examples – 2例-2 • International Primary Care Airways Group (IPAG) primary care workbook 国际呼吸道疾病基层医疗(IPAG) - 基层医疗业务手册 • Available from WONCA 可从WONCA得到帮助 • Addresses diagnosis and management of rhinitis, asthma, COPD提出鼻炎、哮喘、慢阻肺的诊断处理 • Based on GINA, GOLD, ARIA guidelines 以GINA, GOLD, ARIA 指南为基础 • Symptom-based, easy to use 症状为基础,便于使用

  8. Examples – 3例-3 • International Primary Care Respiratory Group (IPCRG) Guidelines 国际呼吸道疾病基层医疗组织(IPCRG)指南 • http://www.theipcrg.org/guidelines/index.php • Entire issue of Primary Care Respiratory Journal 2006;15(1):1-74 呼吸道疾病基层医疗的整体研究杂志2006;15(1):1-74 • Detailed, extensive 细节与延伸

  9. Examples – 4 例-4 • National Heart, Lung, and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma国立心肺血液研究所的哮喘诊治指南 • http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm • Used in USA 在美国的应用 • Update expected in late 2006 今年下半年可望更新 • Joint Taskforce on Practice Parameters • http://www.jcaai.org/为全科??的联合工作组 • Used in USA by specialists; developed by ACAAI, AAAAI 由ACAAI, AAAAI制订,美国专科医生应用

  10. Summary 概要 • The GARD initiative will facilitate the sharing of expertise between primary care physicians and specialists GARDGARD行动将支持其专科医生与基层保健医生之间交流经验 • By facilitating information exchange, GARD can help physicians develop guidelines appropriate for their countries GARD可依靠信息交流, 协助医生制订适合本国情况的指南

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