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AGREEⅡ系统对现行国内外急性胰腺炎指南的评价分析
Evaluation and analysis of the current guidelines for acute pancreatitis using Appraisal of Guidelines for Research and Evaluation II
文章发布日期:2018年05月07日  来源:  作者:王宇,饶友义,郭军,等  点击次数:325次  下载次数:46次

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【摘要】:目的采用AGREEⅡ系统对目前国内外急性胰腺炎指南质量进行评价分析。方法按照纳入和排除标准筛选检索万方、中国知网、维普和PubMed、Cochrane、Elsevier等数据库2005年-2016年急性胰腺炎综合诊治指南。对纳入指南的颁布机构、证据评价依据、发表年份等内容进行统计。采用AGREEⅡ系统对纳入临床指南的质量进行评价。国内外指南评分比较采用独立样本非参数Mann-Whitney U检验。结果共纳入指南/共识10篇,其中国外指南6篇,国内指南4篇。3位评分者对10篇指南的AGREEⅡ评价结果组内相关系数均大于0.75(P值均<0.05),具有极好的一致性。评价结果显示,目前国内外指南中,范围和目的及表达的明晰性领域得分均值较高,分别为50.37%、53.15%,其中国外指南评分平均值高于国内指南(64.51% vs 29.16%,Z=-2.558,P=0011;73.77% vs 22.22%,Z=-2.574,P=0.010);参与人员、制订的严谨性及实用性方面得分均值较低(分别为2870%、30.49%、19.17%),其中在制订的严谨性方面国外指南评分平均值高于国内指南(48.96% vs 2.78%,Z=-2.557,P=0011);指南编辑的独立性方面所有指南评分平均值为41.39%,国外指南评分平均值为68.98%,高于国内指南(0),差异有统计学意义(Z=-2.648,P=0008)。所有国外指南推荐级别均为B级,国内指南均为C级。结论急性胰腺炎指南在参与人员、制订的严谨性及实用性等方面仍有待提高。国外急性胰腺炎指南均为循证指南,可在经过适当修订后使用。而国内指南在严谨性、实用性及编辑独立性等诸多方面距离国际标准仍有一定差距,建议日后进一步规范我国急性胰腺炎循证指南的起草及编辑,促进我国急性胰腺炎的规范诊治。
【Abstract】:ObjectiveTo investigate the quality of the guidelines for acute pancreatitis in China and foreign countries using Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. MethodsAccording to inclusion and exclusion criteria, Wanfang Data, CNKI, VIP, PubMed, Cochrane, and Elsevier were searched for the guidelines for the diagnosis and treatment of acute pancreatitis published from 2005 to 2016. As for the guidelines included, the information on the institutions that issued the guidelines, the basis for evidence evaluation, and the year of issuance was collected. The AGREE II instrument was used to evaluate the quality of the guidelines included in this study. The independent-samples nonparametric Mann-Whitney U test was used to compare the scores of guidelines in China and foreign countries. ResultsA total of 10 guidelines/consensus statements were included, among which 4 were published by China and 6 were published by foreign countries. The AGREE II results of 10 guidelines evaluated by three reviewers had an interclass correlation coefficient of >0.75 (all P<0.05), which showed good consistency. The evaluation results showed that these guidelines had high mean scores of “Scope and Purpose” and “Clarity of Presentation”(50.37% and 53.15%, respectively), and the guidelines in foreign countries had significantly higher mean scores than the guidelines in China (64.51% vs 2916%, Z=-2558,P=0011; 73.77% vs 22.22%, Z=-2574,P=0010). The guidelines had low mean scores of “Stakeholder Involvement”, “Rigour of Development”, and “Applicability” (2870%, 30.49%, and 19.17%, respectively), and the guidelines in foreign countries had a significantly higher mean score of “Rigour of Development” than the guidelines in China (48.96% vs 2.78%, Z=-2.557,P=0.011). All guidelines had a mean score of “Editorial Independence” of 41.39%, and the guidelines in foreign countries had a significantly higher mean score than the guidelines in China (68.98% vs 0, Z=-2.648,P=0.008). The recommendation levels of the guidelines in China and foreign countries were C and B, respectively. Conclusion“Stakeholder Involvement”, “Rigour of Development”, and “Applicability” of the guidelines for acute pancreatitis need to be improved. The guidelines for acute pancreatitis in foreign countries are evidence-based guidelines and can be used after appropriate revision. The overall quality of the guidelines in China are inferior to those in foreign countries in the aspects of “Rigour of Development”, “Applicability”, and “Editorial Independence”, and therefore, it is recommended to further regulate the drafting and editing of evidence-based guidelines for acute pancreatitis in China, in order to promote the standard diagnosis and treatment of acute pancreatitis in China.
【关键字】:胰腺炎; 诊疗准则; 评价研究
【Key words】:pancreatitis; practice guideline; evaluation studies
【引证本文】:
WANG Y, RAO YY, GUO J, et al. Evaluation and analysis of the current guidelines for acute pancreatitis using Appraisal of Guidelines for Research and Evaluation II[J]. J Clin Hepatol, 2018, 34(6): 1225-1230. (in Chinese) 王宇, 饶友义, 郭军, 等. AGREEⅡ系统对现行国内外急性胰腺炎指南的评价分析[J]. 临床肝胆病杂志, 2018, 34(6): 1225-1230.

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