基于AGREEⅡ的儿童疼痛管理临床实践指南质量评价

Quality assessment of clinical practice guidelines on pediatric pain management based on AGREEⅡ

目的 :评价已发布的儿童疼痛管理临床实践指南的质量,综合分析指南推荐建议的共识,为规范我国儿童疼痛管理临床实践指南制定提供参考。方法 :检索2006-2016年间国内外发表的儿童疼痛管理指南,对符合纳入标准的指南采用AGREEⅡ进行质量评价,得出指南的推荐等级。结果 :共检索到相关指南60份,其中有8份符合纳入标准。AGREEⅡ评分显示:纳入指南6个领域(范围和目的、指南制定参与人员、制定严谨性、清晰性与可读性、适用性、编撰的独立性)的平均得分分别为:81.25%、53.82%、46.88%、76.74%、44.27%、42.19%。A级(推荐)0篇,B级(修改完善后推荐)7篇,C级(不推荐)1篇。结论 :现有的儿童疼痛管理临床实践指南总体质量一般。亟须规范指南制定的方法学,包括指南开发过程的严谨性以及报告的清晰性和完整性,制定出包含最新、最佳证据,并能有效指导儿童疼痛管理临床实践的指南,提升儿童疼痛管理临床实践质量。

Objective： To evaluate the quality of clinical practice guidelines （CPGs） published relating to pediatric pain management, analyze and summarize the consensus of included recommendations from those guidelines, and to provide a reference for normatively developing pediatric pain management guidelines suitable for China's Mainland. Methods： Relative guidelines published internationally from 2006 to 2016 were searched, then the quality of included guidelines was evaluated using AGREE Ⅱ, and finally recommended levels of guidelines were given, repsectively. Results： A total of 60 guidelines were retrieved, of which 8 met the inclusion criteria. Average AGREE Ⅱ scores in six domains （Scope and Purpose, Stakeholder Involvement, Rigour of Development, Clarity of Presentation, Applicability and Editorial Independence） were 81.25%, 53.82%, 46.88%, 76.74%, 44.27%, 42.19% separately. No A-class guideline was recommended. 7 guidelines were leveled as B-class （recommended after revise）. 1 guideline was not recommended. Conclusion： These included guidelines were of general quality. The methodological rigor and reporting clarity of guidelines development would need further improvement urgently. Researchers need to develop guidelines for pediatric pain management which could include the latest and best evidences, so as to improve clinical oractice oualitv in pediatric pain management.