全球肺癌筛查指南及共识质量评价

Quality assessment of global lung cancer screening guidelines and consensus

目的了解国内外肺癌筛查指南/共识的研究进展和质量,为我国制定高质量的肺癌筛查指南/共识提供参考依据。方法检索PubMed、Medline、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献服务系统、维普网和万方数据知识服务平台共9个数据库和相关网站关于肺癌筛查指南/共识的文献,采用开发指南研究和评估工具Ⅱ(AGREEⅡ)和国际实践指南报告标准(RIGHT)评价工具对新发布或更新的指南/共识进行质量评价。结果共纳入2015-2020年的9部指南/共识,发布的国家包括美国、中国、加拿大、沙特阿拉伯和南非;AGREEⅡ评价结果显示,范围和目的及清晰性得分较高,严谨性和应用性得分较低;5部指南被判定为A级,均为国外发布的指南,其余4部为B级,包括中国发布的3部指南/共识以及1部南非发布的指南;RIGHT评价结果显示,基本信息和背景报告率较高,评审和质量保证、资金资助和利益冲突报告率较低,其中,报告水平良好的指南5部,报告水平中等的指南/共识4部。综合质量较高的是美国胸科医师学会2018年发布的指南和加拿大预防保健工作组2016年发布的指南。结论肺癌筛查指南/共识的发布国家和机构数量逐渐增加,我国的肺癌筛查指南/共识的质量偏低,需结合循证方法制订出适合我国国情的高质量的肺癌筛查指南/共识,以指导实践。

Objective To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad,and to provide reference for the formulation of high-quality lung cancer screening guidelines in China.Methods Databases including PubMed,Medline,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,SinoMed,VIP and Wanfang Data were searched,websites and important references were also searched by hand retrieval.The Appraisal of Guidelines for Research&EvaluationⅡ(AGREEⅡ)and Reporting Items for Practice Guidelines in Healthcare(RIGHT)were used to assess the quality of newly published or updated guidelines and consensus.Results A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study,with countries including the United States,China,Canada,Saudi Arabia and South Africa.The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low.Five guidelines were judged to be A-level,all of which were published abroad,and the remaining four were B-level,including three guidelines and consensus issued by China and 1 guideline issued by South Africa.The report rate of RIGHT were higher in basic information and background,lower in review and quality assurance,funding and declaration and management of interests.There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level.The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016.Conclusions The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually,but the quality in China remained low.It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.