TY - JOUR
T1 - Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists
AU - Sidiropoulos, P I
AU - Hatemi, G
AU - Song, I-H
AU - Avouac, J
AU - Collantes, E
AU - Hamuryudan, V
AU - Herold, M
AU - Kvien, T K
AU - Mielants, H
AU - Mendoza, J M
AU - Olivieri, I
AU - Østergaard, M
AU - Schachna, L
AU - Sieper, J
AU - Boumpas, D T
AU - Dougados, M
PY - 2008
Y1 - 2008
N2 - OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. METHODS: Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. RESULTS: A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. CONCLUSION: Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.
AB - OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. METHODS: Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. RESULTS: A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. CONCLUSION: Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.
KW - Anti-Inflammatory Agents, Non-Steroidal
KW - Cyclooxygenase 2 Inhibitors
KW - Disease Progression
KW - Dose-Response Relationship, Drug
KW - Drug Administration Schedule
KW - Drug Therapy, Combination
KW - Evidence-Based Medicine
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - International Cooperation
KW - Male
KW - Monitoring, Physiologic
KW - Practice Guidelines as Topic
KW - Randomized Controlled Trials as Topic
KW - Spondylitis, Ankylosing
U2 - 10.1093/rheumatology/kem348
DO - 10.1093/rheumatology/kem348
M3 - Journal article
C2 - 18276738
VL - 47
SP - 355
EP - 361
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 3
ER -