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Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement

机译:儿童消化系统程序的结构和功能:共识声明

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Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients.
机译:消化系统计划为患有复杂先天性或后天性疾病,影响呼吸,吞咽和生长的小儿患者提供了协调的跨学科护理。尽管计划,国家会议,利益团体和早期研究活动的数量激增,但迄今为止,尚无关于航空消化系统患者的共识定义,航空消化系统计划的标准化结构和功能,或有关计划的蓝图。研究优先级。多学科和多机构的空气消化系统提供者使用了Delphi方法,以就与空气消化系统护理有关的4个广泛内容领域达成共识:(1)空气消化系统患者的定义,(2)空气消化系统程序的基本结构和功能, (3)确定航空消化系统的研究重点,以及(4)评估和认可航空消化系统的计划和未来方向。经过3次迭代的调查,通过36%的33个项目中的75%的多数优势或中位数排名的稳定性获得了共识。这包括对空气消化系统患者的标准定义,特定儿科学科参与计划的水平,护理周期的基本组成部分和计划的功能,进食和吞咽评估和治疗,程序范围和数量,研究重点和结果指标,认证,编码和资金。我们提出了航空消化系统护理模型的第一个共识定义,并针对相关人员,基础设施,研究和结果指标提出了具体建议。我们希望这可以为进一步规范护理,制定临床指南并改善消化不良患者的预后提供一个初始框架。
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