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勃起功能障碍评估与治疗的保健模式过程：
保健共识审议团的过程
This paper addresses pertinent issues concerning the role of physicians
in the assessment and treatment of men with complaints of erectile
dysfunction. With the availability of safe and effective oral drug
therapy, the field of erectile dysfunction has expanded rapidly to
encompass multiple disciplines and specialties. Recognizing the need
for evidence-based standards and guidelines in the management of this
common disorder, a multidisciplinary panel of experts was convened
to examine existing literature and practice standards. This panel
employed a modified Delphi methodology to develop consensus on definition
and classification, rational utilization of diagnostic and therapeutic
options, and clinical guidelines for the management of erectile dysfunction
in a primary care setting. A 'Process of Care Model for Erectile Dysfunction'
was thus developed, incorporating a step-wise decision making approach,
defined in terms of relevant processes, actions and outcomes. According
to this method, initial assessment should include a careful clinical
history, focused physical examination and selected laboratory tests.
Subsequent management should be goal-oriented, taking into account
patient and partner needs and preferences. The step-wise treatment
algorithm is based on the selection criteria of ease of administration,
reversibility, relative invasiveness and cost. In addition, common
referral indications for specialized diagnostic testing and treatment
are provided. By assisting the primary physician in selecting appropriate
assessment tools and treatment interventions, the proposed guidelines
are intended to optimize care of the patient with erectile dysfunction.
The panel strongly recommends further research into the causes and
associated risk factors for erectile dysfunction, prevention and the
role of lifestyle modification, and the critical issue of partner-related
sexual dysfunction. Considering the strong relationship between sexual
dysfunction and overall quality of life, it is incumbent upon physicians
to address the sexual needs of their patients in a sensitive and informed
manner.
【引自Int J Impot Res 1999 Apr;11(2):59-70】 |
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