TY -的T1 -应用程序的管理方针s to the assessment of new medicines: driving us forward or holding us back? JF - European Respiratory Journal JO - Eur Respir J SP - 793 LP - 794 DO - 10.1183/09031936.04.00015904 VL - 23 IS - 6 AU - Calverley, P.M.A. AU - Rennard, S.I. Y1 - 2004/06/01 UR - //www.qdcxjkg.com/content/23/6/793.abstract N2 - Clinical management guidelines have made an invaluable contribution in many areas of medicine. By providing recommendations based on an expert assessment of the available evidence, guidelines can identify “best practice” approaches, help drive consistent quality of care, reduce morbidity and mortality, and improve cost-effectiveness. The considerable time, effort and organisation needed to prepare authoritative sets of guidelines provides an imperative to gain the maximum utility from their development. However, it is also important that guidelines are used appropriately. The use of guidelines to address issues other than those for which they were designed can potentially have a detrimental effect on patient care. In chronic obstructive pulmonary disease (COPD), for instance, guidelines from bodies such as the Global Initiative for Chronic Lung Disease (GOLD) 1, the European Respiratory Society (ERS) 2 and the American Thoracic Society (ATS) 3 have helped to establish standards of care, and help drive improved management of COPD. However, the guidelines have also been used increasingly by regulatory authorities to define the requirements for new agents to gain approval, a role that they were never designed to fill. The GOLD guidelines provide a working definition of COPD as a disease state characterised by airflow limitation, which is not fully reversible, and is usually both progressive and associated with an abnormal inflammatory response to noxious particles 1. They also, however, recognise both the heterogeneity of COPD and the difficulties of providing … ER -