Qualität der Therapie von Speicheldrüsenerkrankungen

Zusammenfassung

Die Behandlung von Speicheldrüsenerkrankungen stellt ein wichtiges Segment der HNO-Heilkunde dar. Von der Vielzahl von Speicheldrüsenerkrankungen sieht der einzelne HNO-Arzt allerdings möglicherweise nur wenige Fälle pro Jahr und chirurgische oder endoskopisch minimal-invasive Therapiekonzepte spielen eine wichtige Rolle. Daher kann der Erkenntnisgewinn nicht nur von prospektiven klinischen Studien getragen werden, sondern heute im Wesentlichen durch Meta-Analysen und potentiell auch von Registerdaten. Während eine Vielzahl guter Indikatoren vorhanden ist, um die Funktion der erkrankten Speicheldrüse und deren Besserung unter Therapie zu messen, sind Patient-reported outcome measures (PROMs) bislang nicht ausreichend entwickelt worden. Es ist zu fordern, dass diese Indikatoren auch konsequent in klinischen Studien eingesetzt werden. Perspektivisch könnten dieselben Indikatoren auch für Qualitätskontrollen in der ambulanten und stationären Routine angewandt werden. Die Rahmenbedingungen für einen qualitativ hochwertigen Wissenserwerb sind durch die HNO-Facharzt-Ausbildung, die Verpflichtung der Weiterbildung und durch zertifizierte Speicheldrüsen-Kurse prinzipiell sehr gut, die Vorgaben für spezifische Qualitätsstandards für die Behandlung von Patienten sind jedoch wenig ausgearbeitet. In Abgrenzung zu anderen Fachgebieten, die sich mit Speicheldrüsenerkrankungen beschäftigen, sollte die HNO-Heilkunde Standards mit hoher Qualitätsforderung für die Behandlung von Patienten mit Speicheldrüsenerkrankungen entwickeln.

Abstract

The treatment of salivary gland diseases represents an important segment of otorhinolaryngology. The individual otorhinolaryngologist might, however, see only a few cases per year from a large variety of salivary gland diseases. Surgical and endoscopic minimal-invasive therapy concepts play a key role. Therefore, gain of knowledge cannot only be provided by prospective clinical trials but also by meta-analyses and potentially also by registry data. Many reliable indicators are established to measure the function of a diseased salivary gland or the improvement of its function after therapy. In contrast, patient-reported outcome measures (PROMs) are not sufficiently developed. It has to be demanded that these indicators are consequently used in clinical trials. Perspectively, the same indicators could also be used for quality control for the outpatient and inpatient sector in clinical routine. The framework conditions for high-quality acquisition of knowledge are given by the otorhinolaryngology specialist medical training, the obligation of life-long continuous medical education, and certified salivary gland courses. Nevertheless, the specifications of quality standards for the treatment of patients with salivary gland diseases are not well formulated. In contrast to other disciplines also addressing salivary gland diseases, otorhinolaryngology ought to develop standards with high requirements of quality of care for salivary gland diseases.

Schlüsselwörter

Speicheldrüsen - Qualitätsindikatoren - Qualitätsmanagement - Klinische Register - Evidenz-basierte Medizin - Leitlinien

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