BMC Med Inform Decis Mak - Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

Tópicos

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Resumo

CKGROUND: Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal.METHODS: The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm.RESULTS: The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential.CONCLUSION: An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

Resumo Limpo

ckground postop pulmonari complic remain signific caus morbid follow open upper abdomin surgeri despit advanc periop care howev due poor qualiti primari research uncertainti surround valu prophylact physiotherapi intervent manag patient follow abdomin surgeri persist delphi process propos pragmat methodolog guid clinic practic evid equivocalmethod object develop clinic manag algorithm post oper manag abdomin surgeri patient eleven draft algorithm statement extract extant literatur primari research team verifi rate scientist clinician n electron three round delphi process algorithm statement reach priori defin consensussemiinterquartil rang siqrwer collat algorithmresult five panelist alloc abdomin surgeri delphi panel australia canada sweden south africa draft algorithm statement edit addit statement formul panel reach consensus rate statement four statement rate essentialconclus expert delphi panel interpret equivoc evid physiotherapeut manag patient follow upper abdomin surgeri process consensus clinic manag algorithm formul algorithm can now use clinician guid clinic practic popul

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