乳腺癌筛查指南方法学质量和报告质量的系统评价

Methodological and reporting quality of breast cancer screening guidelines:a systematic review

目的系统评价全球现有乳腺癌筛查指南的方法学质量和报告质量,为我国乳腺癌筛查指南的制订工作提供参考。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、CBM、WanFang Data数据库和相关网站,搜集乳腺癌筛查相关指南,检索时限均为建库至2018年2月。由2名研究者独立筛选文献、提取资料,采用AGREEⅡ工具和RIGHT声明对指南的方法学质量和报告质量进行评价。结果共纳入11篇乳腺癌筛查指南,其中5篇(45%)由美国发布。方法学质量评价结果显示:"范围和目的"、"参与人员"、"严谨性"、"清晰性"、"应用性"和"独立性"领域总体评价结果依次是83、48、60、77、53和79分。6篇指南推荐等级为A,5篇为B。报告质量评价结果显示:3篇报告质量高,其指南中,美国2篇、加拿大1篇。结论乳腺癌筛查指南方法学质量和报告质量均欠佳。指南发布数量呈上升趋势,其制订或更新有不断打破国家和地区界限的趋势。循证指南制订方法已逐渐成为各国制订临床指南的共识和趋势。

ObjectivesTo systematically review the methodological and reporting quality of the current global breast cancer screening guidelines so as to provide useful information for domestic study in the future.MethodsWe searched databases including PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, CBM, WanFang Data and some cancer official websites to collect breast cancer screening guidelines from inception to February, 2018. Two reviewers independently screened literature, extracted data and assessed the quality of the guidelines by using AGREE II tool and RIGHT statement.ResultsA total of 11 guidelines were included, in which 5 guidelines （45%） were issued by the USA. The results of the quality assessment showed that： the average scores in the ＂ scale and objective”, ＂ participants”, ＂ rigorism”, ＂ clarity”, ＂ application”, and ＂ independence” of all guidelines were 83, 48, 60, 77, 53 and 79, respectively. 6 guidelines were evaluated as level A and 5 as level B. For the reporting quality, 3 guidelines were of high quality, including 2 in the USA and 1 in Canada.ConclusionsThe methodological and reporting quality of breast cancer screening guidelines are at present very satisfactory. The quantity of clinical guidelines shows an increasing trend. Multi-country contribution to one guideline is another trend. The evidence-based methodology has been accepted globally in the guideline development.