中国骨科临床实践指南的质量评价

Quality assessment of Chinese clinical practice guidelines in orthopedics

目的评价和分析目前国内已发布的骨科指南。方法计算机检索CNKI、CBM、VIP和WanFang Data数据库,搜集相关的中国骨科临床实践指南,检索时限均为从建库至2016年10月。由2位评价员独立筛选文献、提取资料后,采用AGREEⅡ工具对纳入的指南进行质量评价,计算每个结构域的得分并通过组内相关系数对评价者间的一致性进行评价。结果共纳入54篇骨科临床实践指南,在AGREEⅡ6个结构域的平均得分率为60.44%、21.40%、5.17%、22.17%、6.02%和0.56%。组内相关系数检验结果为0.84,提示评价者间总的一致性非常好。结论国内现有骨科临床实践指南总体质量不高。未来的指南需要在制定的方法学上进一步的提高,尤其是制定的严谨性、应用性和编辑的独立性方面。

Objective To evaluate quality of orthopedic clinical practice guidelines in China by AGREE It Instrument. Methods A systematic search of relevant literature databases （CBM, WanFang Data, VIP and CNKI） was conducted to identify the orthopedic clinical practice guidelines of China published up to October 2016. Guidelines selection and data extraction were independently performed by two authors. AGREE II instrument was used to evaluate the quality of the included guidelines. Intra-class correlation coefficient tests were performed to appraise the uniformity of the overall assessment scores. Results A total of 54 guidelines for orthopedics were finally included. The mean scores of six domains by AGREE Ⅱinstrument were 60.44%, 21.40%, 5.17%, 22.17%, 6.02% and 0.56%. The overall intra-class correlation coefficient was 0.84. Conclusion The quality of orthopedic clinical practice guidelines in China was low or moderate in general. The methodology of making guidelines, especially in terms of rigor of development, applicability and editorial independence, should be improved.