经典高分文献阅读·2019困难气道指南（3）

今日共读   2019困难气道指南（三）

Methods

    Data from included studies were synthesised and consensus共识 from all 10 members of the guideline group was sought to formulate guideline reommendations using a three-round Delphi method [38, 39]. 三轮德尔菲法

    *德尔菲法，也称专家调查法，1946 年由美国兰德公司创始实行，其本质上是一种反馈匿名函询法，其大致流程是在对所要预测的问题征得专家的意见之后，进行整理、归纳、统计，再匿名反馈给各专家，再次征求意见，再集中，再反馈，直至得到一致的意见。该方法是由企业组成一个专门的预测机构，其中包括若干专家和企业预测组织者，按照规定的程序，背靠背地征询专家对未来市场的意见或者判断，然后进行预测的方法。

    These recommendations were based on a number of factors, including: volume and consistency of supportive evidence; applicability and generalisability of the evidence to current practice; and clinical and practical implicationsof recommendations.包括：支持性证据的数量和一致性；证据对当前实践的适用性和普遍性；以及建议的临床和实际意义。

    We determined the level of evidence and graded thestrength of subsequent recommendations using a modififiedversion of the system developed by the Centre for Evidencebased Medicine (Oxford, UK) (Table 2) [40]. Eachrecommendation was graded A to D according to thestrength of the available evidence [41].我们确定了证据的水平，并使用循证医学中心（英国牛津)开发的系统的修改版本对随后的建议的强度进行了分级(表2）[40]。每项建议根据现有证据的强度分为A至D[41]

    Over 3 years the guideline group met 21 times inperson and 14 times remotely in order to develop, draft andfinalise these guidelines. Draft versions were presented atthe 2017 and 2018 Diffificult Airway Society (DAS) annualscientific meetings. We sent an electronic survey to DASmembers (n = 2150) to capture their opinions, preferencesand clinical experiences in ATI, of whom 632 (29%)responded. 

This survey highlighted强调 the need for guidelines for ATI and the role of a standardised technique for trainingand clinical practice.这项调查强调了ATI指南的必要性，以及培训和临床实践的标准化技术的作用。

We also performed a survey of 43 international experts, seeking details on commonly usedstrategies for oxygenation, topicalisation, sedation andperformance of ATI.我们还对43名国际专家进行了调查咨询，寻求有关氧合、局部麻醉、镇静和ATI性能的常用策略的详细信息。

Patient and public involvement was also used to explore the views and experiences of patients who had undergone ATI.his was achieved by conducting a fully anonymised multicentre structured survey of 100 patients, where we explored the self-reported experiences of the overall conduct of ATI. 这是通过对100名患者进行完全匿名的多中心结构化调查来实现的，我们在其中探索了ATI整体实施的自我报告经验。

We consulted an an aesthetic assistant during the preparation of these guidelines and invited a senior anaesthetic nurse and two consultant headand neck surgeons to comment on the final draft.在这些指导方针的准备过程中，我们咨询了一名麻醉助理，并邀请了一名高级麻醉护士和两名头颈外科顾问对最终草案发表评论。

A draft manuscript of these guidelines was then sent to 13 international experts with clinical or academic experiencerelated to ATI to gather specifific comments and feedback onrecommendations and to assess applicability and feasibility.The guideline group considered the responses from expertreviewers to inform the fifinal recommendations. 这些指南的手稿随后被发送给13位具有与ATI相关的临床或学术经验的国际专家，以收集关于建议的具体意见和反馈，并评估其适用性和可行性。

The finaldraft of the guideline was then submitted to DAS executivecommittee for ratifification.指导小组考虑了专家审稿人的答复，从而得出最终的建议。指导方针的最终草案随后提交DAS执行委员会批准。

总之就是我们这份指南相当合规、可信度高及严谨。

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