肝硬化指南方法学和报告质量评价

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肝硬化指南方法学和报告质量评价

狄宝山,贾俊海,刘爱萍,王建成,尚轶,唐艳,田金徽

甘肃省人民医院,甘肃省康复中心医院,甘肃卫生职业学院;甘肃卫生职业学院,甘肃省人民医院,兰州大学第二医院,兰州市第二人民医院,兰州大学循证医学中心

收稿日期:2018-11-27 修回日期:2018-11-27 出版日期:2019-01-25
基金资助:
兰州市人才创新创业项目 (项目编号：2015-RC-65201525；项目名称：亚高原地区急诊疾病谱相关危险因素的研究及急救优化策略)；甘肃软科学专项项目(项目编号：1604ZCRA011；项目名称：城市流浪人员医疗救助模式对策研究)；甘肃省人民医院院内科研基金项目(项目编号：17GSSY2-7；项目名称：甘肃省“医养结合”模式构建及应用研究)

The Methodology and Reporting Quality Assessment of the Clinical Practice Guidelines for Liver Cirrhosis

DI Baoshan,JIA Junhai,LIU Aiping,WANG Jiancheng,SHANG Yi,TANG Yan and TIAN Jinhui

Gansu Provinical Hospital,Gansu Province Hospital Rehabilitation Center,Gansu Health Vocational College,Gansu Lanzhou,甘肃省人民医院,兰州大学第二医院,兰州市第二人民医院,兰州大学循证医学中心

Received:2018-11-27 Revised:2018-11-27 Online:2019-01-25

摘要/Abstract

摘要： 目的：运用指南研究与评价Ⅱ（AGREE Ⅱ）工具及RIGHT清单评价和分析肝硬化临床实践指南的方法学和报告质量，为未来肝硬化指南的制定与报告提供参考和借鉴。方法：系统检索PubMed、EMBASE、CBM、CNKI和Wanfang 5个数据库，以及GIN、SIGN、NGC、NICE 4个指南数据库，并补充检索医脉通网站。两名研究人员独立筛选文献、提取数据，遇到分歧讨论解决或咨询第三方。运用AGREE Ⅱ工具和RIGHT清单评价纳入指南的方法学和报告质量，并计算组内相关系数（ICC）值评价两名研究人员运用AGREE Ⅱ工具评价指南的一致性。结果：共纳入9篇指南。纳入指南发表于2012—2016年，主要来自6个国家，其中日本最多（3篇，33.3%）。8篇（88.9%）指南发表于期刊，1篇（11.1%）来自NICE指南数据库。ICC值为0.895[95%CI（0.872，0.923），P=0.013]。纳入指南6个领域得分依次为范围和目的（34.9%，SD=14.0%）、参与人员（26.5%，SD=18.4%）、制定严谨性（44.4%，SD=12.1%）、表达明晰性（59.9%，SD=13.6%）、应用性（18.8%，SD=8.9%）和编辑独立性（51.9%，SD=16.0%）。纳入指南的平均得分为12.9（SD=2.5），范围为9.5~17.5分。报告充分比例大于50%的条目共7条。结论：超过75%的肝硬化指南于近两年发表，大部分指南来自于亚洲。与国际平均水平相比，肝硬化指南在“表达明晰性”、“制定严谨性”和“编辑独立性”领域的AGREE评分相近或更高，但其余领域的得分均较低。肝硬化指南RIGHT的平均得分较低，且超过一半的条目上未报告的比例大于50%。

Abstract: Objective：To evaluate and analyze the methodology and reporting quality of the clinical practice guidelines for liver cirrhosis by the AGREE Ⅱinstrument and RIGHT checklist，in order to give reference for the formulation and report of guidelines for liver cirrhosis in the future. Methods：We systematically searched five general databases，including PubMed，EMBASE， Chinese Biomedical Literature Database(CBM)，Wanfang database，and China National Knowledge Infrastructure(CNKI)，and four guidelines databases，namely，Guidelines International Network（GIN），Scottish Intercollegiate Guidelines Network（SIGN），National Guideline Clearinghouse（NGC）and National Institute for Health and Clinical Excellence（NICE）.Additionally，we also searched the website of Yimaitong.Two independent reviewers screened and extracted data.When meeting the disagreement， we solved it by discussion or consultation with a third reviewer.Two reviewers evaluated methodology and reporting quality of the included guidelines by AGREE Ⅱ instrument and RIGHT checklist.The consistency was assessed by the ICC value. Results： Nine guidelines were included. These guidelines were published from 2012 to 2016， and mainly from six countries， particularly Japan(three guidelines，33.3%). Eight guidelines (88.9%) were from journals，and one guideline (11.1%) was from the NICE.The consistency between two assessors was high，ICC value was 0.895[95%CI（0.872，0.923），P=0.013]. The scores of six domains were scope and purpose（34.9%，SD=14.0%），stakeholder and involvement（26.5%，SD=18.4%），rigor of development（44.4%，SD=12.1%），clarity of presentation（59.9%，SD=13.6%），applicability（18.8%，SD=8.9%）and editorial independence ( 51.9%，SD=16.0%）， respectively.The average score of reporting quality of guidelines was 12.9（SD=2.5）， which the total score of each guideline ranged from 9.5 to 17.5. There were seven items in which more than 50% guidelines were evaluated as adequately reporting. Conclusion： More than 75% guidelines for liver cirrhosis are published in recent years， and from Asia. By comparing with the average scores of the guidelines worldwide，the scores of guidelines are similar and apparently higher in three domains(rigor of development，clarity of presentation and editorial independence)，the other domains are lower. Meahwhile， the RIGHT scores are relative low. Particularly， there are more than 50% guidelines reported nothing in more than 50% items.

狄宝山,贾俊海,刘爱萍,王建成,尚轶,唐艳,田金徽. 肝硬化指南方法学和报告质量评价[J]. .

DI Baoshan,JIA Junhai,LIU Aiping,WANG Jiancheng,SHANG Yi,TANG Yan and TIAN Jinhui. The Methodology and Reporting Quality Assessment of the Clinical Practice Guidelines for Liver Cirrhosis[J]. .

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