临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (1): 50-.doi: 10.3969 j.issn.1000-3606.2016.01.014

• 循证医学 • 上一篇    下一篇

基于AGREE Ⅱ的儿童泌尿系感染临床实践指南质量现状分析

陈辉, 胡誉怀, 李震宇, 赵盈葶, 罗蕾   

  1. 贵州省人民医院(贵州贵阳 550002)
  • 收稿日期:2016-01-15 出版日期:2016-01-15 发布日期:2016-01-15
  • 通讯作者: 罗蕾 E-mail:292443736@qq.com
  • 基金资助:
    贵阳市科技局资助项目(No.20141001-56);贵州省科技厅资助项目(No.20157132)

Analysis of current situation of the quality of clinical practice guidelines for children with urinary tract infections based on AGREE II

 CHEN Hui, HU Yuhuai, LI Zhenyu, ZHAO Yingting, LUO Lei   

  1. People’s Hospital of Guizhou Province, Guiyang 550002, Guizhou, China
  • Received:2016-01-15 Online:2016-01-15 Published:2016-01-15

摘要: 目的 对全球儿童泌尿系感染(UTI)临床实践指南质量进行评价,为规范制订我国儿童UTI 临床指南提供参考。方法 计算机检索MEDLINE、EMbase、National Guideline Clearinghouse、Guidelines International Network、National Institute for Health and Clinical Excellence,以及万方、中国知网及中国指南协作网(从建库到2015 年1 月)等中英文数据库和相关网站。根据纳入、排除标准筛选公开发表的有关儿童UTI 的临床指南,按照国际公认的指南评价工具(AGREE)分析纳入指南的方法学质量,使用组内相关系数(ICC)进行评价员间一致性检验。结果 共纳入10 篇儿童UTI 指南,覆盖4 个洲9 个组织。指南发布时间跨度为1999—2015 年,其中7 篇为首版,3 篇为更新版。纳入指南主题涉及诊断、管理、预防、危险因素评估和治疗等,均是基于循证证据的指南。纳入指南AGREE Ⅱ评分显示,6 个领域的评价得分分别为88%、57%、54%、98%、26%、44%;纳入7 篇指南的范围及目的、清晰性领域的评分均>50%;英国国家卫生与临床优化研究所(NICE)、阿拉贡健康科学研究所(IACS)发布指南的6 个领域评分均>50%。结论 不同国家和地区儿童UTI 临床指南的质量差别较大。循证是当前临床实践指南的发展趋势,应注重指南制定方法的严谨性、报告的规范性和指南的实用性。

Abstract:  Objectives To evaluate the quality of global clinical practice guidelines for children with urinary tract infection (UTI) and provide reference for the development of the clinical guidelines for Chinese children with UTI. Methods The Medline, Embase, National Guideline Clearinghouse (NGC), guidelines international network (GIN ), national Institute for Health and Clinical Excellence (NICE), Wanfang database, Chinese national knowledge infrastructure (CNKI), Chinese practice guideline network (CPGN, from inception to January 2015 ), and related English and Chinese websites were searched. The published guidelines for children with UTI were screened according to the inclusion and elimination criteria. AGREE was used to evaluate the methodological quality of the guidelines. The consistency among the assessors was evaluated by correlation coefficient (ICC). Results A total of 10 guidelines for children with UTI were included, covering 9 continents and 4 organizations. The published time was from 1999 to 2015, including 7 articles in headed version and 3 articles in updated version. The topics of these guidelines were diagnosis, management, prevention, risk assessment and treatment , and were all evidence-based. The AGREE II score of included guidelines showed that the average scores on six domains were 88%, 57%, 54%, 98%, 26% and 44% respectively. The scores in the field of scope, purpose, and clarity in 7 guidelines were > 50%. The scores of guidelines published by National Institute for Health and Clinical Excellence (NICE) of United Kingdom and Aragon Institute of Health Sciences (IACS) were all >50% in six areas. Conclusions The quality of clinical guidelines for children with UTI in different countries and regions varied greatly. Evidence-based is the trend in the development of clinical practice guidelines. The rigorous methodology, report standardization and practicability of guidelines should be emphasized.