Development of Evidence-Based Clinical Practice Guidelines for Diabetes

• Leonard M. Pogach

  VA New Jersey Health Care System, East Orange, New Jersey

• Stephen A. Brietzke

  The Uniformed Services University of the Health Sciences, Bethesda, Maryland

• Claude L. Cowan, Jr.

  Washington VA Medical Center, Washington, D.C

• Paul Conlin

  Boston VA Health Care System, Boston, Massachusetts

• Debby J. Walder

  Office of Quality and Performance, Department of Veterans Affairs, Washington, D.C

• Clark T. Sawin

  Office of the Medical Inspector, Department of Veterans Affairs, Washington, D.C

抄録

OBJECTIVE—To describe the Veterans Affairs (VA)/Department of Defense (DoD) Clinical Practice Guidelines for diabetes and contrast selected recommendations with those of the American Diabetes Association (ADA). RESEARCH DESIGN AND METHODS—We summarize the general structure of the VA/DoD Guidelines and describe the rationale for recommendations issued in 2003 for glycemic control, management of hypertension, and retinopathy screening. We compare the synthesis of evidence and resulting recommendations for these content areas with the 2004 American Diabetes Association Clinical Practice Recommendations. RESULTS—The VA/DoD Guidelines and the ADA Clinical Practice Recommendations reported similar strength of evidence findings by content area, but clinical recommendations varied. The VA/DoD Guidelines and practice recommendations emphasize the use of data on absolute risk reduction from available published randomized clinical trials rather than relative risk reduction from observational analyses. The VA/DoD Guidelines employ an algorithm-based methodology to guide clinicians through a risk-stratified approach to managing individual patients rather than promoting a single standard for most or all patients without explicit consideration of competing comorbidities. CONCLUSIONS—The VA/DoD Guidelines are intended to guide diabetes care by providing Internet-ready, evidence-based annotations in algorithmic form to help clinicians set and revise individual treatment goals for their patients.

収録刊行物

• Diabetes Care

  Diabetes Care 27 (suppl_2), b82-b89, 2004-05-01

  American Diabetes Association

キーワード

• Advanced and Specialized Nursing
• Endocrinology, Diabetes and Metabolism
• Internal Medicine

詳細情報

• CRID: 1360855569304531840
• NII論文ID: 30026281238
• DOI: 10.2337/diacare.27.suppl_2.b82
• ISSN: 19355548
• ISSN: 01495992
• Web Site: https://diabetesjournals.org/care/article-pdf/27/suppl_2/b82/459394/zdc10504000b82.pdf
• データソース種別:
  • Crossref
  • CiNii Articles