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Evidence-Based Clinical Algorithm for Hypotonia Assessment: To Pardon the Errs

机译:低血钾评估的循证临床算法:原谅错误

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摘要

Despite the many advances in diagnostics, the clinical assessment of children with hypotonia presents a diagnostic challenge for clinicians due to the current subjectivity of the initial clinical assessment. The aim of this paper is to report on an evidence-based clinical algorithm (EBCA) that was developed for the clinical assessment of hypotonia in children as part of the output of a multiphased study towards assisting clinicians in more accurate assessments. This study formed part of a larger advanced mixed methods design. The preceding phases of the study included a systematic review, a survey amongst clinicians, a consensus process (Delphi technique), and a qualitative critique with multiple focus groups. Samples were drawn from three professional groups (occupational therapists, physiotherapists, and paediatricians). Data were analysed at each stage and merged in the development of the EBCA. The EBCA followed a rigorous process of development and critique. The methods for formulating changes in the revision and development of the EBCA are presented together with a description and presentation of the final algorithm for practice. The overarching concepts that guided the development and refinement of the EBCA are described, taking into consideration knowledge translation, evidence-based practice, and the value of EBCAs in addition to recommendations for stakeholder uptake. The EBCA is envisaged to be useful in practice for clinicians who are faced with the assessment of a child that is suspected as having hypotonia via a systematic process in identifying specific characteristics that are associated with low muscle tone.
机译:尽管诊断技术取得了许多进步,但由于目前初始临床评估的主观性,对肌张力低下儿童的临床评估仍对临床医生提出了诊断挑战。本文的目的是报告一种基于证据的临床算法(EBCA),该算法是针对儿童肌张力低下的临床评估而开发的,是一项多阶段研究成果的一部分,旨在协助临床医生进行更准确的评估。这项研究是较大的高级混合方法设计的一部分。该研究的前几个阶段包括系统评价,临床医生之间的调查,共识过程(Delphi技术)以及具有多个焦点小组的定性评论。从三个专业组(职业治疗师,物理治疗师和儿科医生)抽取样本。在每个阶段对数据进行分析,并将其合并到EBCA的开发中。 EBCA遵循了严格的发展和批判过程。提出了制定EBCA修订和开发变更的方法,以及对最终实践算法的描述和介绍。描述了指导EBCA的发展和完善的总体概念,并考虑了知识转化,循证实践以及EBCA的价值以及对利益相关者的建议。 EBCA被认为对于临床医生在实践中很有用,因为他们需要通过系统的过程来鉴定与低肌张力相关的特定特征,以评估怀疑患有低渗症的儿童。

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