자극제 사용장애 국제 임상진료지침의 임상적 합의 권고에 대한 국내 적용 적절성 평가

초록

Objectives: This study evaluated expert consensus among Korean psychiatrists experienced in treating substance use disorders on the clinical consensus recommendations of the American Society of Addiction Medicine (ASAM) and American Academy of Addiction Psychiatry (AAAP) Clinical Practice Guideline on the Management of Stimulant Use Disorder, as part of a guideline adaptation for Korea. Methods: A two-stage structured expert consensus survey was conducted. Before Stage 1, the research team internally appraised the recommendations for domestic acceptability and clinical importance. In Stage 1, five experts reviewed and refined selected recommendations, including preliminary quantitative ratings by two experts. In Stage 2, 14 of 19 invited experts rated 50 items on a nine-point scale. Consensus was predefined as ≥75% of valid respondents selecting a score of 7–9. Results: In the prespecified valid-response analysis, all 50 items met the consensus threshold, with consensus rates of 76.9%–100.0%; 17 achieved 100.0%. However, Recommendations 3, 5a, and 16a did not meet the threshold in a sensitivity analysis using all 14 panelists as the denominator. Recommendation 5a met the primary consensus criterion (83.3%; 10/12), whereas a supplementary question on specifying minimum years of clinical experience did not (71.4%). Revised wording without a specific duration was subsequently developed based on free-text responses. Conclusion: Most ASAM/AAAP clinical consensus recommendations showed high acceptability among Korean psychiatrists experienced in substance use disorder treatment. However, consensus for several recommendations was sensitive to the handling of non-responses, indicating the need for further contextual review during Korean adaptation.

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