基于AGREEⅡ对肺动脉高压临床实践指南的系统评价

Systematic Assessment of Clinical Practice Guidelines for Pulmonary Hypertension Based on AGREEⅡ

目的:分析近五年国内外已公开发布的肺动脉高压临床实践指南的质量,以进一步为临床实践提供参考。方法:检索国内外文献数据库、指南数据库及网站,按照纳入和排除标准筛选指南,并使用AGREEⅡ评估工具对所纳入的指南进行评价,4名评价者依次从AGREEⅡ的6个领域(即指南的范围与目的、参与人员、制定的严谨性、清晰性、应用性、独立性)对每个指南进行具体评分,最后进行综合评估。结果:共纳入5篇肺动脉高压临床实践指南。在评价员一致性良好的前提下,该5篇指南在AGREEⅡ评分的6个领域平均得分率分别为78.32%、63.05%、78.27%、67.97%、67.53%、59.13%,2篇推荐级别为A级(推荐),其余3篇推荐级别为B级(不同程度修改完善后推荐)。结论:近五年肺动脉高压临床实践指南总体质量较高,但在编辑的独立性方面仍需进一步加强。此外,借鉴国外指南时须结合我国具体临床情况做出恰当选择。

Objective： To analyze the quality of clinical practice guidelines for pulmonary hypertension published in recent five years and provide reference for clinical practice. Methods： the domestic and foreign literature database, the guide database and the website were retrieved, and the guidelines which were acquired by sifting according to the criteria for inclusion and exclusion, was evaluated with the AGREE II assessment tool. Each guideline were marked four evaluators in turn from the 6 fields of AGREE II, including the scope and purpose of the guide, the participant, the preciseness, clarity, application and independence of the established process, and a comprehensive assessment finally was given. Results： A total of 5 pulmonary hypertension clinical practice guidelines were evaluated. On the premise of the evaluators with good consistency, the average scores of the 5 guidelines in the 6 fields of AGREE II score were 78.32%, 63.05%, 78.27%, 67.97%, 67.53%, 59.13%, in which the recommended grades of two guidelines are both A, and those of the others are all B. Conclusion： the clinical practice guidelines for pulmonary hypertension in the past five years are of high quality, but the independence of editors needs to be further strengthened. In addition, drawing on foreign guidelines should be combined with the specific clinical situations in China, so as to make appropriate choices.