Development Of Evidence-based Practice Protocols Of Exercise-based Cardiac Rehabilitation For Patients With Acute STEMI

ObjectiveIntergrate the recommendations from clinical practice guidelines,syntheses,relevant systematic review or meta-analysis and consensus,develop an evidence-based practice protocol of exercise-based cardiac rehabilitation for patients with acute ST-elevation myocardial infarction,and evaluate the quality of it.To provide scientific references of exercise-based cardiac rehabilitation for patients with acute STEMI.Methods1.Search the clinical practice guidelines,syntheses,relevant systematic review or meta-analysis and consensus on exercise-based cardiac rehabilitation,and evaluate the quality of the included literature.2.Use the AGREE Ⅱ to assess the quality of clinical practice guidelines.syntheses literature is evaluated by selecting the appropriate quality assessment tools according to the type of original research on which the original text is based.AMSTAR were used for evaluation systematic review and the quality of consensuses were evaluated by the tool of JBI.3.Integration the recommendations from the evidence of clinical practice guidelines,syntheses,systematic review or meta-analysis,consensus and evaluation the quality of the evidences.4.Invite clinical experts to evaluate the feasibility,appropriateness,meaningfulness and effectiveness(FAME)of the evidences of exercise-based cardiac rehabilitation.5.According to the evidences and the expert’s opinions,development of evidence-based practice protocols of exercise-based cardiac rehabilitation for patients with acute STEMI.Results1.Search for clinical practice guideline,including a total of 7guidelines.Using AGREEⅡ to evaluate the guidelines,the standard score of scope and purpose,stakeholder involvement,rigour of development,clarity of persentation,applicability and editorial independence are 85.45%、70.63%、67.26%、82.05%、67.06%、90.48%.The quality of 5 guidelines are A level,and the quality of the other 2 guidelines are B level.2.Total of 4 systematic reviews were included and the results of quality evaluation show that the main methodological quality defects are lack of pre-design plan,criteria for study inclusion excluding publication status,excluded literatures were not list and not evaluated possible publication bias.3.Total of 3 consensuses were included and although the results of quality evaluation show that one consensus does not list the positions of the author;the other consensus does not record the positions and the names of the units to which they belong,panel discussion suggested that it could be used as a reference for this study.4.And summarizes the evidence of exercise rehabilitation from the aspects of evaluation、exercise test、exercise type、safety and supervision.By the guidelines,systematic review and consensus.5.10 clinical experts were invited to evaluate the evidence by FAME.Conclusion“ evidence-based practice protocols of exercise-based cardiac rehabilitation for patients with acute STEMI”can provide guidances for clinical practice,but this protocol has not yet been applied in clinical,and its effect remains to be verified.