IDSA：2016新版曲霉菌病诊治指南.pptxVIP

IDSA：2016 新版曲霉菌病诊治指南 Patterson TF, Denning DW, Fishman JA, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America.[J]. Clinical infectious diseases, 2016. 卢永辉 2016.07.11 1 微信公众号：感染时间 步步非烟 2 1. Establish initial level of confidence Study design Initial confidence in an estimate of effect Randomized trials High confidence Observational studies Low confidence 2. Consider lowering or raising level of confidence Reasons for considering lowering or raising confidence Lower if Higher if Risk of bias Inconsistency Indirectness Imprecision Publication bias Large effect Dose response All plausible confounding bias Would reduce a demonstrated effect or Would suggest a spurious effect if no effect was observed 3. Final level of confidence rating Confidence in an estimate of effect across those considerations High Moderate Low Very low 1. Rating the Quality of the Evidence 3 2. Determinants of the Strength of Recommendation Quality (certainty) of evidence Resources and cost Patients’ values preferences Balance between Benefits, harms, burdens 4 Strong Weak Population: Most people in this situation would want the recommended course of action and only a small proportion would not Healthcare workers: Most people should receive the recommended course of action Policy makers: The recommendation can be adapted as a policy in most situations Population: The majority of people in this situation would want the recommended course of action, but many would not Healthcare workers: Be prepared to help people to make a decision that is consistent with their own values/decision aids and shared decision making Policy makers: There is a need for substantial debate and involvement of stakeholders 3. Implication of the Strength of Recommendation 5 曲霉菌病是感染曲霉菌引起的一种真菌病，可累及皮肤、黏膜、眼、鼻、支气管、肺、胃肠道、神经系统、骨骼等多器官系统，严重者导致败血症，病例呈世界性分布。病原体曲霉菌属丝状真菌，是一种常见的条件致病性真菌，广泛分布于自然界，其感染者并不少见。 时隔 8 年，美国感染病学会（IDS