摘要
目的评价、分析脑性瘫痪临床实践指南的质量,比较各指南的异同,为临床循证决策及实践提供参考。方法电子检索平台检索中国知网、万方数据库、中国生物医学文献服务系统、SCI及PubMed数据库。同时检索NGC、GIN、NICE、AAN等指南数据库,最后补充手工检索医脉通网站。检索截至日期为2018年7月6日。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。运用临床指南与评估系统(AGREEⅡ)对指南进行方法学质量评价,并计算ICC值评估一致性。结果检索获得文献共计487篇,经过筛选,最终纳入11部指南;纳入指南主要来自3个国家,其中中国(4部,36.3%),英国(5部,45.5%),美国指南(2部,18.2%)。11部指南6个领域的AGREEⅡ得分范围在54.36%~85.86%。指南总体质量评价为5个A级,6个B级。组内相关系数检验结果均>0.763,提示评价者之间总的一致性好。采用Stata13.0软件同时针对NICE制定的指南与其他机构制定的指南进行对比分析,P<0.05认为差异具有统计学意义。结论脑性瘫痪临床实践指南的总体质量较好,尤其是NICE制定的5部指南在6个领域得分均较高,为我国脑性瘫痪临床实践提供明确的推荐意见。
Objective To analyze the quality of clinical practice guidelines of cerebral palsy,comparing the similarities and differences among these guidelines.Methods The eligible studies were systematically retrieved from CNKI,Wanfang,SinoMed,SCI,and PubMed database.Also,searching guidelines databases,such as National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),National Institute for Health and Clinical Excellence(NICE)and American Academy of Neurology(AAN).Finally,the Yimaitong website could be retrieved in supplementary.The retrieval deadline was July 6th,2018.Two independent reviewers screened the references and extracted the data.The discrepancies were resolved by discussing or consulting with a third reviewer.Thus,clinical guidelines and AGREEⅡwere used to evaluate the methodological quality and assess the consistency of intraclass correlation coefficient(ICC).Results A total of 487 references were retrieved from the databases.Finally,11 guidelines were included after two phases of screening.These guidelines were from three countries,China(four guidelines,36.3%),the UK(five guidelines,45.5%),and the USA(two guidelines,18.2%).Eleven guidelines in six fields of AGREEⅡhave a score of 54.36%~85.86%.The overall quality of the guidelines was rated at five As and six Bs.The test results of intra-group correlation indexes were>0.763,indicating a good overall consistency among the estimators,and NICE guidelines were of higher quality than those of other agencies.Stata13.0 software was used.At the same time,the guidelines for NICE were compared and analyzed with those of other institutions.P<0.05 was considered statistically significant.Conclusion The overall quality of the clinical practice guidelines of cerebral palsy is good,especially the five guidelines of the NICE scored high in six fields.These provide recommendations for the clinical practice of cerebral palsy in China.
作者
钱晓玲
王亚莉
豆欣蔓
DOU Xinman(The Second Hospital of Lanzhou University,Lanzhou 730000,China)
出处
《中国全科医学》
CAS
北大核心
2021年第S01期18-22,共5页
Chinese General Practice
基金
甘肃省卫生行业科研计划项目(GAWSKY2017-62)
