Guidelines - Management of chonic pain in primary care

L’objectif de ce GPC est de fournir aux professionnels de première ligne des outils pour améliorer la qualité des soins proposés en Belgique dans le cadre de la prise en charge de la douleur chronique, y compris une meilleure évaluation du patient et de la situation, une prise en charge multidisciplinaire, pas seulement basée sur une approche médicamenteuse par étapes, mais aussi sur une approche non-médicamenteuse. Ce guide est une mise à jour de la recommandation de la Société Scientifique de Médecine Générale (SSMG) de 2004 1, dont la nouveauté est notamment d’être présentée sous la forme de réponses à des questions cliniques. Ce guide a été réalisé à la demande du groupe de travail « Réalisation de Recommandations de Première Ligne », subventionné par l’Institut National d’Assurance Maladie-Invalidité (INAMI)

A Tool to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals (CAPOCI): Design and Validation Study

BackgroundUser-friendly information at the point of care for health care professionals should be well structured, rapidly accessible, comprehensive, and trustworthy. The reliability of information and the associated methodological process must be clear. There is no standard tool to evaluate the trustworthiness of such point-of-care (POC) information. ObjectiveWe aim to develop and validate a new tool for assessment of trustworthiness of evidence-based POC resources to enhance the quality of POC resources and facilitate evidence-based practice. MethodsWe designed the Critical Appraisal of Point-of-Care Information (CAPOCI) tool based on the criteria important for assessment of trustworthiness of POC information, reported in a previously published review. A group of health care professionals and methodologists (the authors of this paper) defined criteria for the CAPOCI tool in an iterative process of discussion and pilot testing until consensus was reached. In the next step, all criteria were subject to content validation with a Delphi study. We invited an international panel of 10 experts to rate their agreement with the relevance and wording of the criteria and to give feedback. Consensus was reached when 70% of the experts agreed. When no consensus was reached, we reformulated the criteria based on the experts’ comments for a next round of the Delphi study. This process was repeated until consensus was reached for each criterion. In a last step, the interrater reliability of the CAPOCI tool was calculated with a 2-tailed Kendall tau correlation coefficient to quantify the agreement between 2 users who piloted the CAPOCI tool on 5 POC resources. Two scoring systems were tested: a 3-point ordinal scale and a 7-point Likert scale. ResultsAfter validation, the CAPOCI tool was designed with 11 criteria that focused on methodological quality and author-related information. The criteria assess authorship, literature search, use of preappraised evidence, critical appraisal of evidence, expert opinions, peer review, timeliness and updating, conflict of interest, and commercial support. Interrater agreement showed substantial agreement between 2 users for scoring with the 3-point ordinal scale (τ=.621, P<.01) and scoring with the 7-point Likert scale (τ=.677, P<.01). ConclusionsThe CAPOCI tool may support validation teams in the assessment of trustworthiness of POC resources. It may also provide guidance for producers of POC resources