过敏学中的科学到实践差距：跨卫生系统决定因素与知识转化策略的批判性评价。

文献信息

中文摘要

引言： 循证医学假设高质量研究一旦产生，就会到达临床。在过敏学中，这一假设屡屡被违背。坚实的证据不断积累，而其在日常实践中的采纳仍然不完整，并且在不同卫生系统之间存在差异。
涵盖领域： 本批判性评价利用当前数据描述过敏学中的科学到实践差距，数据来源于对PubMed、MEDLINE、Embase和Cochrane Library的检索，覆盖2015年1月至2026年3月。它考察了该差距在制度和经济背景下的决定因素，并评价了证据基础最强的知识转化（KT）策略。针对过敏性鼻炎、哮喘和AIT，量化了ARIA、GINA和EAACI的依从性，其中AIT采纳估计被视为因环境而异，而非普遍适用。比较了高收入欧盟国家、英国以及低收入和中等收入国家之间的四个决定因素领域：教育、利益冲突、报销和本地适应，并评价了五种KT策略。
专家意见： 该差距是可测量的、具有临床后果的，并且是可改变的。其持续存在更多反映结构和政策因素，而非临床医生的知识。根据迄今记录，审计与反馈和学术详细访问相结合，并根据本地环境进行调整，同时得到临床决策工具支持，可提供最持久的改善。过敏学学会应将实施科学和独立的利益冲突管理纳入其战略优先事项。

英文摘要

INTRODUCTION: Evidence-based medicine assumes that high-quality research, once produced, will reach the bedside. In allergology this assumption is repeatedly violated. Solid evidence accumulates while its uptake in daily practice remains incomplete and variable across health systems.
AREAS COVERED: This critical appraisal characterizes the science-to-practice gap in allergology using current data, drawn from a search of PubMed, MEDLINE, Embase, and the Cochrane Library covering January 2015 to March 2026. It examines the gap's determinants across institutional and economic contexts and evaluates knowledge-translation (KT) strategies with the strongest evidence base. ARIA, GINA, and EAACI adherence is quantified for allergic rhinitis, asthma, and AIT, with AIT uptake estimates treated as setting-specific rather than universal. Four determinant domains, education, conflicts of interest, reimbursement, and local adaptation, are compared across high-income EU countries, the UK, and low- and middle-income countries, and five KT strategies are appraised.
EXPERT OPINION: The gap is measurable, clinically consequential, and modifiable. Its persistence reflects structural and policy factors more than clinician knowledge. Combinations of audit-and-feedback and academic detailing, tailored to local environments and supported by clinical decision tools, offer the most durable improvement documented to date. Allergological societies should integrate implementation science and independent conflict-of-interest management into their strategic priorities.