<International Circulation>: How can the guidelines be made clearer and easier to implement?

  《国际循环》: 如何把指南制订得更清晰并且更易于执行呢？

    Prof. Stone:  We are hoping to simplify the guidelines. The ATP3 was an extraordinary effort and took the cholesterol field forward， but now in 2011， many primary clinicians want guidelines that are simpler to use. We are hoping that we can have a strict evidence-based set of guidelines that will differ from ATP3 which had both depth but breadth. We are going to focus just on depth. We are going to answer three critical questions and then with the integrated guidelines， more questions will be answered. We are starting the foundation of what we think will be the guidelines process of the future.

    Stone教授:  我们希望能够简化指南。ATP3是额外的努力，并且推动了胆固醇研究领域的研究进展，但是在目前2011年，许多主要的临床医生希望指南能够更容易应用。我们期望我们能够拥有一套严格的基于循证医学系统的指南，并且在深度而不是深度上都与ATP3不同。我们将仅仅致力于深度方面。我们将回答3个临床问题，然后由于拥有了完备的指南，许多问题都能够被解答。

    <International Circulation>: How difficult was it to narrow the questions down to just three questions?

   《国际循环》: 将这些问题压缩为3个问题有多难？

    Prof. Stone: That took time.

    Stone教授: 这需要时间。

    <International Circulation>: What is the difference in making an evidence-based recommendation as level A or level B? In the hands of a physician who can see a level B recommendation without a conflicting level A recommendation， how do they approach that decision-making process? Is there really an importance in making a level A and level B distinction?

   《国际循环》: 以循证医学为基础的制订的建议如A水平或者B水平，有什么差异？对于内科医生，能够看到一个B级的推荐建议，而没有与之相冲突的A级别的建议，他们是如何进行决策过程的？做A级别或B级别的区分是否真的很重要?

    Prof. Stone: There are several answers to that. Firstly， it is important that clinicians understand what recommendations are supported by the highest level of evidence because these will be recommendations that they can feel fully confident about. Then they need to understand that there are areas where we do not have as good evidence. Therefore， if they want to engage in risk conversations or treatment conversations with their patients to inform and educate them， they do not have the same level of confidence in doing so with the other recommendations. We think that will make for a more informed clinician and a more informed patient. At the core is to understand what recommendations we have the highest level of evidence for. That‘s an important point.

    Stone教授: 关于那个问题有许多答案。首先，临床医生理解最高级别的证据支持指南推荐的是什么是非常重要的，因为这样他们就能够有充分的信心被建议。他们还需要理解我们缺乏很好的证据支持的方面。因此，如果他们想跟他们的病人进行治疗或者风险谈话以进行告知并且宣教，由于其他的指南建议，他们就没有同样的信心这样做。我们认为这将使临床医生和病人更加了解指南。了解我们拥有最高级别的证据的指南推荐是核心问题。这是一个非常重要的一点。