透明质酸治疗膝骨关节炎的临床实践指南质量评价

透明质酸治疗膝骨关节炎的临床实践指南质量评价

荀杨芹,张元元,王建成,贾俊海,尚轶,唐艳,田金徽

兰州大学公共卫生学院,兰州大学基础医学院,甘肃省人民医院,甘肃省康复中心医院,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:2018-10-25
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 Quality Assessment of Clinical Practice Guidelines on the Treatment of Knee Osteoarthritis with Hyaluronic Acid

XUN Yangqin,ZHANG Yuanyuan,WANG Jiancheng,JIA Junhai,SHANG Yi,TANG Yan and TIAN Jinhui

The School of Public Health,Lanzhou University,School of Basic Medical Sciences of Lanzhou University,Gansu Lanzhou,甘肃省人民医院,甘肃省康复中心医院,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:2018-10-25

摘要/Abstract

摘要： 目的：了解目前透明质酸治疗膝骨关节炎的临床实践指南现状，评价、分析透明质酸治疗膝骨关节炎的临床实践指南的质量，为临床实践提供明确的推荐意见。方法：通过检索主要数据库，纳入有关透明质酸治疗膝骨关节炎的指南。运用指南研究与评价Ⅱ（AGREEⅡ）工具评价纳入指南的质量，预试验结果运用SPSS 19.0统计软件计算组内相关系数（ICC）值验证一致性，所得数据运用Excel 2013 进行整理。结果：共纳入16部指南。AGREE Ⅱ评分有较大差异，指南推荐意见不一致。12.5%的指南不推荐使用透明质酸治疗膝骨关节炎，但62.5%的指南认为在某些情况下该干预措施是有效的。剩余25%的指南只提供了一个不确定的推荐意见或无推荐意见。结论：目前不同指南对于透明质酸治疗膝骨关节炎的推荐意见不同甚至相反，使得医生在临床实践中很难做出科学的决策。透明质酸治疗膝骨关节炎指南的整体质量有待提高，制订指南需有统一、标准且合适的方法学参与，以确保使用该指南的临床医生作出科学的临床决策。

Abstract: Objective：To investigate the current situation of global clinical practice guidelines on the treatment of knee osteoarthritis with hyaluronic acid， to evaluate and analyze the quality of the clinical practice guidelines for the treatment of knee osteoarthritis with hyaluronic acid, in order to provide clear recommendations for clinical practice. Methods：A systematic literature search was performed in PubMed， EMBASE， Cochrane Library， Web of Science， CNKI， Wanfang， CBM(Chinese Biomedical Literature Database)， NGC（National Guideline Clearinghouse）， NICE（National Institute for Health and Clinical Excellence）for guidelines on the treatment of knee osteoarthritis with hyaluronic acid.The internationally recognized guideline evaluation tool， appraisal of guidelines for research and evaluation Ⅱ (AGREE Ⅱ) was applied to assess the methodological quality of guidelines.The pre-test results were verified by SPSS 19.0 statistical software to calculate the correlation coefficient (ICC) values in the group. The data were compiled using Excel 2013. Results：A total of 16 guidelines were identified that met our inclusion criteria.AGREE II domain scores were variable across the included guidelines, and the guidelines recommendations were inconsistent. Overall， 12.5% of the included guidelines recommended against the use of hyaluronic acid in the treatment of knee osteoarthritis， while 62.5% deemed the treatment an appropriate intervention under certain scenarios.The remaining 25% of the guidelines provided either an uncertain recommendation or no recommendation at all. Conclusion：At present,different guidelines for the treatment of knee osteoarthritis with hyaluronic acid are different or even opposite, which making it difficult for doctors to make scientific decisions in clinical practice. The overall quality of the guidelines for the treatment of knee osteoarthritis with hyaluronic acid needs to be improved,and guidelines should be developed with a uniform, standard and appropriate methodological participation to ensure that doctors using the guidelines make scientific clinical decisions.

荀杨芹,张元元,王建成,贾俊海,尚轶,唐艳,田金徽. 透明质酸治疗膝骨关节炎的临床实践指南质量评价[J]. .

XUN Yangqin,ZHANG Yuanyuan,WANG Jiancheng,JIA Junhai,SHANG Yi,TANG Yan and TIAN Jinhui. The Quality Assessment of Clinical Practice Guidelines on the Treatment of Knee Osteoarthritis with Hyaluronic Acid[J]. .

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