全球指南临床适用性评价工具现状的系统评价

Global guideline clinical applicability evaluation tool:a systematic review

目的了解全球指南临床适用性评价工具现状,为循证建立指南临床适用性评价指标体系提供依据。方法计算机检索7个生物医学文献数据库、6个指南数据库及16个学术机构与卫生行政部门网站,搜集有关指南临床适用性评价工具的文献,检索时限均为建库至2019年4月。由2名研究者独立筛选文献、提取资料后,采用主题综合法初拟出指南临床适用性的评价指标。结果共纳入19篇文献,其中专门针对指南临床适用性的评价工具4个,涉及指南临床适用性评价条目的评价工具15个。通过梳理比较,发现这些工具在评价者、评价领域、评价条目等方面均存在差异。结论全球现有指南临床适用性评价工具的目标针对性不强、指标完整性欠佳、对评价者的指南方法学知识要求较高,尚缺乏从指南目标用户视角出发的指南临床适用性评价工具。

Objectives To investigate the current status of the clinical applicability evaluation tools,and to provide some foundation for establishment of the clinical applicability evaluation index system.Methods 7 databases,6 guideline databases and 16 academic institutions and the administrative department of health website were systematically searched from inception to April 2019.Two reviewers independently screened literature,extracted data and then included the literature related to the applicability of clinical guidelines.The CPG clinical applicability evaluation index was initially prepared through the subject comprehensive method.Results A total of 19 articles were finally included.Among them,there were 4 evaluation tools for the clinical applicability of the guidelines,and 15 evaluation tools for the guideline clinical applicability evaluation items.Through combing and comparison,we found that these tools had differences in evaluators,evaluation fields and items.Conclusions The global guidelines for clinical applicability assessment tools have different kinds of problems,such as that the tools are not targeted,the indicators are not well-formed,and the methodological knowledge requirement of the evaluators is high.There is still a lack of guidelines for clinical applicability assessment tools from target users’view.